How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,965Professionalmedian $3,311 · 10th to 90th $2,399 to $7,413
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 $1,995.26 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,995.26 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $2,398.83 Typical High $2,884.03 | Professional | None | $1,995.26 | $2,398.83 | $2,884.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $11,481.54 | Facility | None | $1,412.54 | $3,801.89 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,454.71 Median $3,235.94 Typical High $4,466.84 | Professional | None | $2,454.71 | $3,235.94 | $4,466.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,548.82 Median $2,041.74 Typical High $2,818.38 | Professional | 62 · Two surgeons | $1,548.82 | $2,041.74 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $398.11 Median $512.86 Typical High $707.95 | Professional | 80 · Assistant surgeon | $398.11 | $512.86 | $707.95 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $446.68 Typical High $616.60 | Professional | AS · PA/NP assist | $346.74 | $446.68 | $616.60 |
BCBS Kansas City Setting Professional Modifier None Typical Low $2,238.72 Median $2,511.89 Typical High $3,630.78 | Professional | None | $2,238.72 | $2,511.89 | $3,630.78 |
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 $2,398.83 Median $2,691.53 Typical High $4,897.79 | Professional | None | $2,398.83 | $2,691.53 | $4,897.79 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,380.38 Typical High $11,220.18 | Facility | None | $54.95 | $1,380.38 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $2,818.38 Median $5,370.32 Typical High $16,982.44 | Professional | None | $2,818.38 | $5,370.32 | $16,982.44 |
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 $2,511.89 Median $3,630.78 Typical High $6,456.54 | Professional | None | $2,511.89 | $3,630.78 | $6,456.54 |
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 $1,000.00 Median $1,202.26 Typical High $1,230.27 | Professional | 52 · Reduced service | $1,000.00 | $1,202.26 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $407.38 Median $489.78 Typical High $501.19 | Professional | 53 · Discontinued | $407.38 | $489.78 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,513.56 Median $1,819.70 Typical High $1,862.09 | Professional | 54 · Surgery only | $1,513.56 | $1,819.70 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $302.00 Median $363.08 Typical High $371.54 | Professional | 55 · Aftercare only | $302.00 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $239.88 Typical High $245.47 | Professional | 56 · Pre-op care only | $199.53 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,412.54 Median $1,698.24 Typical High $1,737.80 | Professional | 78 · Unplanned return to OR | $1,412.54 | $1,698.24 | $1,737.80 |
Where Missouri sits
The same service costs 6.0 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· 22nd of 51
$3,162
AK $9,772TX $1,622
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.