How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,965Professionalmedian $1,820 · 10th to 90th $1,413 to $3,715
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 $1,698.24 Median $5,623.41 Typical High $9,549.93 | Facility | None | $1,698.24 | $5,623.41 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,348.96 Typical High $1,659.59 | Professional | None | $1,096.48 | $1,348.96 | $1,659.59 |
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 $1,445.44 Median $1,819.70 Typical High $2,630.27 | Professional | None | $1,445.44 | $1,819.70 | $2,630.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $912.01 Median $1,148.15 Typical High $1,621.81 | Professional | 62 · Two surgeons | $912.01 | $1,148.15 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $234.42 Median $288.40 Typical High $416.87 | Professional | 80 · Assistant surgeon | $234.42 | $288.40 | $416.87 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $204.17 Median $251.19 Typical High $363.08 | Professional | AS · PA/NP assist | $204.17 | $251.19 | $363.08 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,348.96 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,348.96 | $1,479.11 | $2,089.30 |
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 $1,348.96 Median $1,584.89 Typical High $3,235.94 | Professional | None | $1,348.96 | $1,584.89 | $3,235.94 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,348.96 Typical High $9,772.37 | Facility | None | $54.95 | $1,348.96 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $1,445.44 Median $3,548.13 Typical High $10,471.29 | Professional | None | $1,445.44 | $3,548.13 | $10,471.29 |
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 $1,412.54 Median $1,949.84 Typical High $3,715.35 | Professional | None | $1,412.54 | $1,949.84 | $3,715.35 |
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 $549.54 Median $676.08 Typical High $707.95 | Professional | 52 · Reduced service | $549.54 | $676.08 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $269.15 Typical High $281.84 | Professional | 53 · Discontinued | $218.78 | $269.15 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $1,023.29 Typical High $1,047.13 | Professional | 54 · Surgery only | $812.83 | $1,023.29 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $204.17 Typical High $208.93 | Professional | 55 · Aftercare only | $162.18 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $134.90 Typical High $141.25 | Professional | 56 · Pre-op care only | $109.65 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $954.99 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $758.58 | $954.99 | $977.24 |
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· 24th of 51
$1,820
AK $5,754TX $813
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.