How much rates vary
Facilitymedian $3,162 · 10th to 90th $724 to $7,413Professionalmedian $813 · 10th to 90th $676 to $1,820
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 $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $676.08 Typical High $1,659.59 | Professional | None | $549.54 | $676.08 | $1,659.59 |
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 $676.08 Median $794.33 Typical High $1,318.26 | Professional | None | $676.08 | $794.33 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,202.26 Typical High $1,949.84 | Professional | 50 · Both sides | $1,023.29 | $1,202.26 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $426.58 Median $501.19 Typical High $812.83 | Professional | 62 · Two surgeons | $426.58 | $501.19 | $812.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $107.15 Median $128.82 Typical High $208.93 | Professional | 80 · Assistant surgeon | $107.15 | $128.82 | $208.93 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $112.20 Typical High $181.97 | Professional | AS · PA/NP assist | $95.50 | $112.20 | $181.97 |
BCBS Kansas City Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $977.24 | Professional | None | $645.65 | $707.95 | $977.24 |
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 $676.08 Median $812.83 Typical High $1,621.81 | Professional | None | $676.08 | $812.83 | $1,621.81 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,137.96 Typical High $5,888.44 | Facility | None | $54.95 | $2,137.96 | $5,888.44 |
Medica Setting Professional Modifier None Typical Low $776.25 Median $1,819.70 Typical High $5,370.32 | Professional | None | $776.25 | $1,819.70 | $5,370.32 |
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 $724.44 Median $1,000.00 Typical High $1,862.09 | Professional | None | $724.44 | $1,000.00 | $1,862.09 |
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 $275.42 Median $338.84 Typical High $354.81 | Professional | 52 · Reduced service | $275.42 | $338.84 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $138.04 Typical High $141.25 | Professional | 53 · Discontinued | $109.65 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $512.86 Typical High $524.81 | Professional | 54 · Surgery only | $416.87 | $512.86 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $102.33 Typical High $104.71 | Professional | 55 · Aftercare only | $83.18 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $67.61 Typical High $70.79 | Professional | 56 · Pre-op care only | $54.95 | $67.61 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $478.63 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $389.05 | $478.63 | $489.78 |
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· 32nd of 51
$955
AK $2,884TX $417
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.