How much rates vary
Facilitymedian $2,818 · 10th to 90th $1,096 to $9,550Professionalmedian $575 · 10th to 90th $417 to $1,479
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 $338.84 Median $416.87 Typical High $1,000.00 | Professional | None | $338.84 | $416.87 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,479.11 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $812.83 | Professional | None | $416.87 | $588.84 | $812.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $263.03 Median $363.08 Typical High $501.19 | Professional | 62 · Two surgeons | $263.03 | $363.08 | $501.19 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $67.61 Median $93.33 Typical High $128.82 | Professional | 80 · Assistant surgeon | $67.61 | $93.33 | $128.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $58.88 Median $81.28 Typical High $112.20 | Professional | AS · PA/NP assist | $58.88 | $81.28 | $112.20 |
BCBS Kansas City Setting Professional Modifier None Typical Low $389.05 Median $436.52 Typical High $602.56 | Professional | None | $389.05 | $436.52 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,137.96 Typical High $2,691.53 | Facility | None | $645.65 | $2,137.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $1,000.00 | Professional | None | $416.87 | $501.19 | $1,000.00 |
Medica Setting Facility Modifier None Typical Low $741.31 Median $2,754.23 Typical High $26,302.68 | Facility | None | $741.31 | $2,754.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $457.09 Median $1,096.48 Typical High $4,265.80 | Professional | None | $457.09 | $1,096.48 | $4,265.80 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $436.52 Median $588.84 Typical High $1,148.15 | Professional | None | $436.52 | $588.84 | $1,148.15 |
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 $169.82 Median $208.93 Typical High $213.80 | Professional | 52 · Reduced service | $169.82 | $208.93 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $83.18 Typical High $85.11 | Professional | 53 · Discontinued | $67.61 | $83.18 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $251.19 Median $316.23 Typical High $323.59 | Professional | 54 · Surgery only | $251.19 | $316.23 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $63.10 Typical High $64.57 | Professional | 55 · Aftercare only | $50.12 | $63.10 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $41.69 Typical High $42.66 | Professional | 56 · Pre-op care only | $33.88 | $41.69 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $295.12 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $234.42 | $295.12 | $302.00 |
Where Missouri sits
The same service costs 7.1 times more in Alaska than in Utah. 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· 25th of 51
$676
AK $2,042UT $288
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.