How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,965Professionalmedian $1,514 · 10th to 90th $1,096 to $3,020
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 $1,479.11 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,479.11 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,202.26 Typical High $1,479.11 | Professional | None | $1,000.00 | $1,202.26 | $1,479.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $13,182.57 | Facility | None | $1,412.54 | $3,801.89 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,047.13 Median $1,513.56 Typical High $2,137.96 | Professional | None | $1,047.13 | $1,513.56 | $2,137.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $660.69 Median $954.99 Typical High $1,348.96 | Professional | 62 · Two surgeons | $660.69 | $954.99 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $165.96 Median $239.88 Typical High $346.74 | Professional | 80 · Assistant surgeon | $165.96 | $239.88 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $144.54 Median $213.80 Typical High $302.00 | Professional | AS · PA/NP assist | $144.54 | $213.80 | $302.00 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,148.15 Median $1,288.25 Typical High $1,905.46 | Professional | None | $1,148.15 | $1,288.25 | $1,905.46 |
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 $1,148.15 Median $1,348.96 Typical High $2,344.23 | Professional | None | $1,148.15 | $1,348.96 | $2,344.23 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,230.27 Typical High $11,220.18 | Facility | None | $54.95 | $1,230.27 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $1,380.38 Median $2,691.53 Typical High $8,912.51 | Professional | None | $1,380.38 | $2,691.53 | $8,912.51 |
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 $1,230.27 Median $1,778.28 Typical High $3,235.94 | Professional | None | $1,230.27 | $1,778.28 | $3,235.94 |
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 $602.56 Typical High $616.60 | Professional | 52 · Reduced service | $501.19 | $602.56 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $245.47 Typical High $251.19 | Professional | 53 · Discontinued | $199.53 | $245.47 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $912.01 Typical High $933.25 | Professional | 54 · Surgery only | $758.58 | $912.01 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $181.97 Typical High $186.21 | Professional | 55 · Aftercare only | $151.36 | $181.97 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $120.23 Typical High $123.03 | Professional | 56 · Pre-op care only | $100.00 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $851.14 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $707.95 | $851.14 | $870.96 |
Where Missouri sits
The same service costs 5.6 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· 22nd of 51
$1,514
AK $5,012UT $891
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.