How much rates vary
Facilitymedian $4,467 · 10th to 90th $646 to $12,303Professionalmedian $2,089 · 10th to 90th $1,549 to $5,248
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 $1,778.28 Median $5,623.41 Typical High $8,511.38 | Facility | None | $1,778.28 | $5,623.41 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,737.80 Typical High $1,905.46 | Professional | None | $1,445.44 | $1,737.80 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $6,025.60 Typical High $16,218.10 | Facility | None | $1,412.54 | $6,025.60 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,621.81 Median $1,949.84 Typical High $2,951.21 | Professional | None | $1,621.81 | $1,949.84 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,023.29 Median $1,202.26 Typical High $1,862.09 | Professional | 62 · Two surgeons | $1,023.29 | $1,202.26 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $263.03 Median $309.03 Typical High $467.74 | Professional | 80 · Assistant surgeon | $263.03 | $309.03 | $467.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $229.09 Median $269.15 Typical High $407.38 | Professional | AS · PA/NP assist | $229.09 | $269.15 | $407.38 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,698.24 Median $1,819.70 Typical High $2,344.23 | Professional | None | $1,698.24 | $1,819.70 | $2,344.23 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,445.44 Typical High $6,760.83 | Facility | None | $489.78 | $1,445.44 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,905.46 Typical High $3,311.31 | Professional | None | $1,445.44 | $1,905.46 | $3,311.31 |
Medica Setting Facility Modifier None Typical Low $562.34 Median $2,884.03 Typical High $11,481.54 | Facility | None | $562.34 | $2,884.03 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $1,737.80 Median $3,162.28 Typical High $12,302.69 | Professional | None | $1,737.80 | $3,162.28 | $12,302.69 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,344.23 Typical High $11,220.18 | Facility | None | $467.74 | $2,344.23 | $11,220.18 |
United Setting Professional Modifier None Typical Low $1,548.82 Median $2,691.53 Typical High $3,548.13 | Professional | None | $1,548.82 | $2,691.53 | $3,548.13 |
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 $724.44 Median $851.14 Typical High $891.25 | Professional | 52 · Reduced service | $724.44 | $851.14 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $338.84 Typical High $354.81 | Professional | 53 · Discontinued | $288.40 | $338.84 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,071.52 Median $1,288.25 Typical High $1,318.26 | Professional | 54 · Surgery only | $1,071.52 | $1,288.25 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $213.80 Median $257.04 Typical High $263.03 | Professional | 55 · Aftercare only | $213.80 | $257.04 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $169.82 Typical High $177.83 | Professional | 56 · Pre-op care only | $144.54 | $169.82 | $177.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,000.00 Median $1,202.26 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $1,000.00 | $1,202.26 | $1,230.27 |
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· 30th of 51
$2,089
AK $7,079TX $1,175
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.