How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,148 to $10,233Professionalmedian $1,820 · 10th to 90th $1,288 to $4,677
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 $10,232.93 | Facility | None | $2,089.30 | $5,623.41 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,258.93 Typical High $2,754.23 | Professional | None | $1,000.00 | $1,258.93 | $2,754.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,801.89 Typical High $9,549.93 | Facility | None | $1,318.26 | $3,801.89 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,862.09 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,862.09 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,148.15 Typical High $1,548.82 | Professional | 62 · Two surgeons | $870.96 | $1,148.15 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $295.12 Typical High $389.05 | Professional | 80 · Assistant surgeon | $223.87 | $295.12 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $257.04 Typical High $338.84 | Professional | AS · PA/NP assist | $194.98 | $257.04 | $338.84 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $1,778.28 | Professional | None | $1,174.90 | $1,288.25 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,162.28 Typical High $4,677.35 | Facility | None | $707.95 | $3,162.28 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $2,951.21 | Professional | None | $1,258.93 | $1,513.56 | $2,951.21 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $3,090.30 Typical High $16,218.10 | Facility | None | $54.95 | $3,090.30 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $1,412.54 Median $3,388.44 Typical High $9,772.37 | Professional | None | $1,412.54 | $3,388.44 | $9,772.37 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $4,168.69 Typical High $10,715.19 | Facility | None | $1,513.56 | $4,168.69 | $10,715.19 |
United Setting Professional Modifier None Typical Low $1,348.96 Median $1,862.09 Typical High $3,388.44 | Professional | None | $1,348.96 | $1,862.09 | $3,388.44 |
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 $501.19 Median $630.96 Typical High $645.65 | Professional | 52 · Reduced service | $501.19 | $630.96 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $251.19 Typical High $257.04 | Professional | 53 · Discontinued | $199.53 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $933.25 Typical High $977.24 | Professional | 54 · Surgery only | $758.58 | $933.25 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $186.21 Typical High $194.98 | Professional | 55 · Aftercare only | $151.36 | $186.21 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $125.89 Typical High $128.82 | Professional | 56 · Pre-op care only | $100.00 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $870.96 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $707.95 | $870.96 | $912.01 |
Where Missouri sits
The same service costs 6.9 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· 29th of 51
$1,862
AK $5,370TX $776
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.