How much rates vary
Facilitymedian $5,888 · 10th to 90th $1,202 to $12,023Professionalmedian $490 · 10th to 90th $295 to $1,349
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 $478.63 Median $575.44 Typical High $1,174.90 | Professional | None | $478.63 | $575.44 | $1,174.90 |
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 $295.12 Median $467.74 Typical High $630.96 | Professional | None | $295.12 | $467.74 | $630.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $446.68 Median $691.83 Typical High $954.99 | Professional | 50 · Both sides | $446.68 | $691.83 | $954.99 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $186.21 Median $288.40 Typical High $398.11 | Professional | 62 · Two surgeons | $186.21 | $288.40 | $398.11 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $46.77 Median $74.13 Typical High $102.33 | Professional | 80 · Assistant surgeon | $46.77 | $74.13 | $102.33 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $40.74 Median $63.10 Typical High $89.13 | Professional | AS · PA/NP assist | $40.74 | $63.10 | $89.13 |
BCBS Kansas City Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $562.34 | Professional | None | $346.74 | $467.74 | $562.34 |
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 $478.63 Median $630.96 Typical High $1,096.48 | Professional | None | $478.63 | $630.96 | $1,096.48 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $5,888.44 Typical High $9,332.54 | Facility | None | $758.58 | $5,888.44 | $9,332.54 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $537.03 Typical High $4,168.69 | Professional | None | $316.23 | $537.03 | $4,168.69 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $4,786.30 Typical High $10,471.29 | Facility | None | $1,000.00 | $4,786.30 | $10,471.29 |
United Setting Professional Modifier None Typical Low $288.40 Median $436.52 Typical High $630.96 | Professional | None | $288.40 | $436.52 | $630.96 |
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 $239.88 Median $281.84 Typical High $295.12 | Professional | 52 · Reduced service | $239.88 | $281.84 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $112.20 Typical High $117.49 | Professional | 53 · Discontinued | $95.50 | $112.20 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $426.58 Typical High $446.68 | Professional | 54 · Surgery only | $363.08 | $426.58 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $85.11 Typical High $89.13 | Professional | 55 · Aftercare only | $72.44 | $85.11 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $56.23 Typical High $58.88 | Professional | 56 · Pre-op care only | $47.86 | $56.23 | $58.88 |
Where Missouri sits
The same service costs 10.5 times more in Alaska than in Hawaii. 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
$550
AK $2,344HI $224
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.