How much rates vary
Facilitymedian $2,884 · 10th to 90th $537 to $10,471Professionalmedian $1,622 · 10th to 90th $1,230 to $4,467
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 $2,454.71 Median $5,623.41 Typical High $13,803.84 | Facility | None | $2,454.71 | $5,623.41 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $1,202.26 Typical High $2,884.03 | Professional | None | $954.99 | $1,202.26 | $2,884.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $4,466.84 Typical High $12,882.50 | Facility | None | $1,412.54 | $4,466.84 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,348.96 Median $1,621.81 Typical High $2,398.83 | Professional | None | $1,348.96 | $1,621.81 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $851.14 Median $1,023.29 Typical High $1,513.56 | Professional | 62 · Two surgeons | $851.14 | $1,023.29 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $213.80 Median $263.03 Typical High $389.05 | Professional | 80 · Assistant surgeon | $213.80 | $263.03 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $186.21 Median $229.09 Typical High $338.84 | Professional | AS · PA/NP assist | $186.21 | $229.09 | $338.84 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,096.48 Median $1,230.27 Typical High $1,698.24 | Professional | None | $1,096.48 | $1,230.27 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,691.53 | Facility | None | $489.78 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $2,818.38 | Professional | None | $1,174.90 | $1,445.44 | $2,818.38 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,288.25 Typical High $9,772.37 | Facility | None | $54.95 | $1,288.25 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $1,348.96 Median $3,162.28 Typical High $9,120.11 | Professional | None | $1,348.96 | $3,162.28 | $9,120.11 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,290.87 Typical High $10,964.78 | Facility | None | $467.74 | $2,290.87 | $10,964.78 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $1,778.28 Typical High $3,235.94 | Professional | None | $1,288.25 | $1,778.28 | $3,235.94 |
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 $478.63 Median $588.84 Typical High $602.56 | Professional | 52 · Reduced service | $478.63 | $588.84 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $234.42 Typical High $245.47 | Professional | 53 · Discontinued | $190.55 | $234.42 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $891.25 Typical High $912.01 | Professional | 54 · Surgery only | $707.95 | $891.25 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $177.83 Typical High $181.97 | Professional | 55 · Aftercare only | $141.25 | $177.83 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $117.49 Typical High $123.03 | Professional | 56 · Pre-op care only | $95.50 | $117.49 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $831.76 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $660.69 | $831.76 | $851.14 |
Where Missouri sits
The same service costs 7.1 times more in Alaska than in Texas. 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· 22nd of 51
$1,660
AK $5,012TX $708
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.