How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,965Professionalmedian $2,630 · 10th to 90th $2,138 to $6,026
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 $1,819.70 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,819.70 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $2,187.76 Typical High $2,570.40 | Professional | None | $1,819.70 | $2,187.76 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $12,882.50 | Facility | None | $1,412.54 | $3,801.89 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,187.76 Median $2,630.27 Typical High $3,801.89 | Professional | None | $2,187.76 | $2,630.27 | $3,801.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $354.81 Median $426.58 Typical High $616.60 | Professional | 80 · Assistant surgeon | $354.81 | $426.58 | $616.60 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $371.54 Typical High $537.03 | Professional | AS · PA/NP assist | $309.03 | $371.54 | $537.03 |
BCBS Kansas City Setting Professional Modifier None Typical Low $2,041.74 Median $2,238.72 Typical High $3,235.94 | Professional | None | $2,041.74 | $2,238.72 | $3,235.94 |
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 $2,137.96 Median $2,398.83 Typical High $4,677.35 | Professional | None | $2,137.96 | $2,398.83 | $4,677.35 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,380.38 Typical High $11,481.54 | Facility | None | $54.95 | $1,380.38 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $2,570.40 Median $4,897.79 Typical High $15,135.61 | Professional | None | $2,570.40 | $4,897.79 | $15,135.61 |
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 $2,238.72 Median $3,235.94 Typical High $5,888.44 | Professional | None | $2,238.72 | $3,235.94 | $5,888.44 |
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 $891.25 Median $1,071.52 Typical High $1,122.02 | Professional | 52 · Reduced service | $891.25 | $1,071.52 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $436.52 Typical High $446.68 | Professional | 53 · Discontinued | $363.08 | $436.52 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,621.81 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,348.96 | $1,621.81 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $323.59 Typical High $331.13 | Professional | 55 · Aftercare only | $269.15 | $323.59 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $218.78 Typical High $223.87 | Professional | 56 · Pre-op care only | $181.97 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,513.56 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,513.56 | $1,548.82 |
Where Missouri sits
The same service costs 8.1 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
$2,630
AK $8,913TX $1,096
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.