How much rates vary
Facilitymedian $3,162 · 10th to 90th $724 to $7,586Professionalmedian $1,230 · 10th to 90th $871 to $3,890
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 $691.83 Median $870.96 Typical High $2,511.89 | Professional | None | $691.83 | $870.96 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $10,964.78 | Facility | None | $1,412.54 | $3,801.89 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $1,659.59 | Professional | None | $912.01 | $1,230.27 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,862.09 Typical High $2,511.89 | Professional | 50 · Both sides | $1,380.38 | $1,862.09 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $199.53 Typical High $269.15 | Professional | 80 · Assistant surgeon | $147.91 | $199.53 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $173.78 Typical High $234.42 | Professional | AS · PA/NP assist | $128.82 | $173.78 | $234.42 |
BCBS Kansas City Setting Professional Modifier None Typical Low $812.83 Median $891.25 Typical High $1,258.93 | Professional | None | $812.83 | $891.25 | $1,258.93 |
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 $870.96 Median $1,047.13 Typical High $2,041.74 | Professional | None | $870.96 | $1,047.13 | $2,041.74 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,187.76 Typical High $6,606.93 | Facility | None | $54.95 | $2,187.76 | $6,606.93 |
Medica Setting Professional Modifier None Typical Low $954.99 Median $2,290.87 Typical High $6,760.83 | Professional | None | $954.99 | $2,290.87 | $6,760.83 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,388.44 Typical High $6,760.83 | Facility | None | $1,000.00 | $3,388.44 | $6,760.83 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,288.25 Typical High $2,344.23 | Professional | None | $912.01 | $1,288.25 | $2,344.23 |
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 $346.74 Median $436.52 Typical High $446.68 | Professional | 52 · Reduced service | $346.74 | $436.52 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $173.78 Typical High $177.83 | Professional | 53 · Discontinued | $138.04 | $173.78 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $645.65 Typical High $676.08 | Professional | 54 · Surgery only | $524.81 | $645.65 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $128.82 Typical High $134.90 | Professional | 55 · Aftercare only | $104.71 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $87.10 Typical High $89.13 | Professional | 56 · Pre-op care only | $69.18 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $602.56 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $489.78 | $602.56 | $630.96 |
Where Missouri sits
The same service costs 6.5 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· 26th of 51
$1,259
AK $3,715TX $575
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.