How much rates vary
Facilitymedian $5,012 · 10th to 90th $1,445 to $12,882Professionalmedian $2,512 · 10th to 90th $1,698 to $6,310
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 $1,862.09 Median $5,623.41 Typical High $8,511.38 | Facility | None | $1,862.09 | $5,623.41 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,479.11 Median $1,778.28 Typical High $1,949.84 | Professional | None | $1,479.11 | $1,778.28 | $1,949.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $5,370.32 Typical High $12,302.69 | Facility | None | $1,412.54 | $5,370.32 | $12,302.69 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,905.46 Median $2,454.71 Typical High $3,162.28 | Professional | None | $1,905.46 | $2,454.71 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,202.26 Median $1,548.82 Typical High $1,995.26 | Professional | 62 · Two surgeons | $1,202.26 | $1,548.82 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $302.00 Median $389.05 Typical High $501.19 | Professional | 80 · Assistant surgeon | $302.00 | $389.05 | $501.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $346.74 Typical High $446.68 | Professional | AS · PA/NP assist | $263.03 | $346.74 | $446.68 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,698.24 Median $1,819.70 Typical High $2,398.83 | Professional | None | $1,698.24 | $1,819.70 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $4,786.30 Typical High $6,760.83 | Facility | None | $1,621.81 | $4,786.30 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $1,995.26 Typical High $3,467.37 | Professional | None | $1,513.56 | $1,995.26 | $3,467.37 |
Medica Setting Facility Modifier None Typical Low $1,412.54 Median $5,011.87 Typical High $22,387.21 | Facility | None | $1,412.54 | $5,011.87 | $22,387.21 |
Medica Setting Professional Modifier None Typical Low $1,905.46 Median $3,311.31 Typical High $12,589.25 | Professional | None | $1,905.46 | $3,311.31 | $12,589.25 |
United Setting Facility Modifier None Typical Low $977.24 Median $5,128.61 Typical High $13,489.63 | Facility | None | $977.24 | $5,128.61 | $13,489.63 |
United Setting Professional Modifier None Typical Low $1,621.81 Median $2,754.23 Typical High $3,715.35 | Professional | None | $1,621.81 | $2,754.23 | $3,715.35 |
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 $741.31 Median $891.25 Typical High $912.01 | Professional | 52 · Reduced service | $741.31 | $891.25 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $302.00 Median $354.81 Typical High $371.54 | Professional | 53 · Discontinued | $302.00 | $354.81 | $371.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,122.02 Median $1,318.26 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,122.02 | $1,318.26 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $223.87 Median $263.03 Typical High $275.42 | Professional | 55 · Aftercare only | $223.87 | $263.03 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $147.91 Median $177.83 Typical High $186.21 | Professional | 56 · Pre-op care only | $147.91 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,047.13 Median $1,230.27 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $1,047.13 | $1,230.27 | $1,288.25 |
Where Missouri sits
The same service costs 4.5 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.
Physician feeFacility fee
AK $16,794KY $3,774
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.