How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,202 to $10,715Professionalmedian $813 · 10th to 90th $550 to $2,291
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $2,089.30 Median $5,623.41 Typical High $8,709.64 | Facility | None | $2,089.30 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $2,511.89 | Professional | None | $457.09 | $562.34 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $831.76 Typical High $1,148.15 | Professional | None | $562.34 | $831.76 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $524.81 Typical High $724.44 | Professional | 62 · Two surgeons | $354.81 | $524.81 | $724.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $134.90 Typical High $181.97 | Professional | 80 · Assistant surgeon | $89.13 | $134.90 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $117.49 Typical High $158.49 | Professional | AS · PA/NP assist | $77.62 | $117.49 | $158.49 |
BCBS Kansas City Setting Professional Modifier None Typical Low $524.81 Median $588.84 Typical High $812.83 | Professional | None | $524.81 | $588.84 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $2,884.03 Typical High $3,801.89 | Facility | None | $912.01 | $2,884.03 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $1,348.96 | Professional | None | $562.34 | $660.69 | $1,348.96 |
Medica Setting Facility Modifier None Typical Low $870.96 Median $4,073.80 Typical High $26,302.68 | Facility | None | $870.96 | $4,073.80 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $602.56 Median $1,479.11 Typical High $4,365.16 | Professional | None | $602.56 | $1,479.11 | $4,365.16 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,981.07 | $8,709.64 |
United Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $1,548.82 | Professional | None | $588.84 | $794.33 | $1,548.82 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $229.09 Median $281.84 Typical High $288.40 | Professional | 52 · Reduced service | $229.09 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $112.20 Typical High $114.82 | Professional | 53 · Discontinued | $91.20 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $416.87 Typical High $436.52 | Professional | 54 · Surgery only | $338.84 | $416.87 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $85.11 Typical High $87.10 | Professional | 55 · Aftercare only | $67.61 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $56.23 Typical High $57.54 | Professional | 56 · Pre-op care only | $45.71 | $56.23 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $398.11 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $316.23 | $398.11 | $407.38 |
Where Missouri sits
The same service costs 6.9 times more in Alaska than in Utah. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Missouri· 17th of 51
$1,023
AK $2,754UT $398
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.