How much rates vary
Facilitymedian $3,802 · 10th to 90th $631 to $12,303Professionalmedian $3,162 · 10th to 90th $2,344 to $7,762
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 $2,511.89 Median $5,623.41 Typical High $8,511.38 | Facility | None | $2,511.89 | $5,623.41 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $2,089.30 Median $2,511.89 Typical High $2,570.40 | Professional | None | $2,089.30 | $2,511.89 | $2,570.40 |
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 $2,511.89 Median $2,951.21 Typical High $4,265.80 | Professional | None | $2,511.89 | $2,951.21 | $4,265.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,584.89 Median $1,862.09 Typical High $2,691.53 | Professional | 62 · Two surgeons | $1,584.89 | $1,862.09 | $2,691.53 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $398.11 Median $467.74 Typical High $676.08 | Professional | 80 · Assistant surgeon | $398.11 | $467.74 | $676.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $346.74 Median $416.87 Typical High $588.84 | Professional | AS · PA/NP assist | $346.74 | $416.87 | $588.84 |
BCBS Kansas City Setting Professional Modifier None Typical Low $2,454.71 Median $2,630.27 Typical High $3,388.44 | Professional | None | $2,454.71 | $2,630.27 | $3,388.44 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $741.31 Typical High $2,691.53 | Facility | None | $489.78 | $741.31 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $2,137.96 Median $2,818.38 Typical High $4,786.30 | Professional | None | $2,137.96 | $2,818.38 | $4,786.30 |
Medica Setting Facility Modifier None Typical Low $562.34 Median $3,090.30 Typical High $11,481.54 | Facility | None | $562.34 | $3,090.30 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $2,570.40 Median $4,570.88 Typical High $17,782.79 | Professional | None | $2,570.40 | $4,570.88 | $17,782.79 |
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 $2,238.72 Median $3,890.45 Typical High $5,248.07 | Professional | None | $2,238.72 | $3,890.45 | $5,248.07 |
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 $1,047.13 Median $1,230.27 Typical High $1,288.25 | Professional | 52 · Reduced service | $1,047.13 | $1,230.27 | $1,288.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $416.87 Median $501.19 Typical High $512.86 | Professional | 53 · Discontinued | $416.87 | $501.19 | $512.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $1,862.09 Typical High $1,949.84 | Professional | 54 · Surgery only | $1,584.89 | $1,862.09 | $1,949.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $371.54 Typical High $389.05 | Professional | 55 · Aftercare only | $316.23 | $371.54 | $389.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $245.47 Typical High $257.04 | Professional | 56 · Pre-op care only | $208.93 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $1,737.80 Typical High $1,819.70 | Professional | 78 · Unplanned return to OR | $1,479.11 | $1,737.80 | $1,819.70 |
Where Missouri sits
The same service costs 24.0 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· 23rd of 51
$3,162
AK $10,233TX $427
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.