How much rates vary
Facilitymedian $4,467 · 10th to 90th $631 to $12,303Professionalmedian $2,399 · 10th to 90th $1,738 to $5,754
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 $1,949.84 Median $5,623.41 Typical High $8,511.38 | Facility | None | $1,949.84 | $5,623.41 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,905.46 Typical High $2,041.74 | Professional | None | $1,584.89 | $1,905.46 | $2,041.74 |
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 $1,862.09 Median $2,238.72 Typical High $3,162.28 | Professional | None | $1,862.09 | $2,238.72 | $3,162.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $354.81 Typical High $501.19 | Professional | 80 · Assistant surgeon | $295.12 | $354.81 | $501.19 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $263.03 Median $309.03 Typical High $446.68 | Professional | AS · PA/NP assist | $263.03 | $309.03 | $446.68 |
BCBS Setting Professional Modifier None Typical Low $1,819.70 Median $1,995.26 Typical High $2,570.40 | Professional | None | $1,819.70 | $1,995.26 | $2,570.40 |
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 $1,584.89 Median $2,089.30 Typical High $3,630.78 | Professional | None | $1,584.89 | $2,089.30 | $3,630.78 |
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 $1,949.84 Median $3,467.37 Typical High $13,182.57 | Professional | None | $1,949.84 | $3,467.37 | $13,182.57 |
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 $1,698.24 Median $2,951.21 Typical High $3,890.45 | Professional | None | $1,698.24 | $2,951.21 | $3,890.45 |
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 $776.25 Median $933.25 Typical High $977.24 | Professional | 52 · Reduced service | $776.25 | $933.25 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $371.54 Typical High $389.05 | Professional | 53 · Discontinued | $316.23 | $371.54 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,174.90 Median $1,380.38 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,174.90 | $1,380.38 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $234.42 Median $281.84 Typical High $288.40 | Professional | 55 · Aftercare only | $234.42 | $281.84 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $186.21 Typical High $194.98 | Professional | 56 · Pre-op care only | $158.49 | $186.21 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,096.48 Median $1,288.25 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $1,096.48 | $1,288.25 | $1,348.96 |
Where Missouri sits
The same service costs 5.9 times more in Alaska than in Utah. 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· 22nd of 51
$2,455
AK $7,762UT $1,318
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.