How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,259 to $12,023Professionalmedian $490 · 10th to 90th $275 to $1,380
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 $1,174.90 Median $4,466.84 Typical High $9,549.93 | Facility | None | $1,174.90 | $4,466.84 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $977.24 | Professional | None | $501.19 | $602.56 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,548.82 Median $6,918.31 Typical High $13,182.57 | Facility | None | $1,548.82 | $6,918.31 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $446.68 Typical High $588.84 | Professional | None | $275.42 | $446.68 | $588.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $407.38 Median $645.65 Typical High $891.25 | Professional | 50 · Both sides | $407.38 | $645.65 | $891.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $173.78 Median $275.42 Typical High $371.54 | Professional | 62 · Two surgeons | $173.78 | $275.42 | $371.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $43.65 Median $69.18 Typical High $95.50 | Professional | 80 · Assistant surgeon | $43.65 | $69.18 | $95.50 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $38.02 Median $60.26 Typical High $83.18 | Professional | AS · PA/NP assist | $38.02 | $60.26 | $83.18 |
BCBS Setting Professional Modifier None Typical Low $371.54 Median $501.19 Typical High $602.56 | Professional | None | $371.54 | $501.19 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $6,760.83 Typical High $16,982.44 | Facility | None | $1,548.82 | $6,760.83 | $16,982.44 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $1,148.15 | Professional | None | $501.19 | $660.69 | $1,148.15 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $5,888.44 Typical High $10,000.00 | Facility | None | $758.58 | $5,888.44 | $10,000.00 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $512.86 Typical High $4,466.84 | Professional | None | $295.12 | $512.86 | $4,466.84 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $5,248.07 Typical High $10,471.29 | Facility | None | $1,000.00 | $5,248.07 | $10,471.29 |
United Setting Professional Modifier None Typical Low $257.04 Median $407.38 Typical High $588.84 | Professional | None | $257.04 | $407.38 | $588.84 |
5 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 $251.19 Median $295.12 Typical High $309.03 | Professional | 52 · Reduced service | $251.19 | $295.12 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $120.23 Typical High $123.03 | Professional | 53 · Discontinued | $100.00 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $446.68 Typical High $467.74 | Professional | 54 · Surgery only | $380.19 | $446.68 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $89.13 Typical High $93.33 | Professional | 55 · Aftercare only | $75.86 | $89.13 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $60.26 Typical High $61.66 | Professional | 56 · Pre-op care only | $50.12 | $60.26 | $61.66 |
Where Missouri sits
The same service costs 10.0 times more in Alaska than in Kentucky. 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· 37th of 51
$575
AK $2,455KY $245
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.