How much rates vary
Facilitymedian $3,162 · 10th to 90th $525 to $12,023Professionalmedian $1,820 · 10th to 90th $1,349 to $4,467
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 $1,202.26 Median $1,445.44 Typical High $1,584.89 | Professional | None | $1,202.26 | $1,445.44 | $1,584.89 |
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 $1,412.54 Median $1,659.59 Typical High $2,454.71 | Professional | None | $1,412.54 | $1,659.59 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $891.25 Median $1,047.13 Typical High $1,513.56 | Professional | 62 · Two surgeons | $891.25 | $1,047.13 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $269.15 Typical High $389.05 | Professional | 80 · Assistant surgeon | $223.87 | $269.15 | $389.05 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $199.53 Median $234.42 Typical High $338.84 | Professional | AS · PA/NP assist | $199.53 | $234.42 | $338.84 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,445.44 Median $1,548.82 Typical High $1,995.26 | Professional | None | $1,445.44 | $1,548.82 | $1,995.26 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,691.53 | Facility | None | $489.78 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,621.81 Typical High $2,754.23 | Professional | None | $1,230.27 | $1,621.81 | $2,754.23 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,348.96 Typical High $11,481.54 | Facility | None | $54.95 | $1,348.96 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $1,445.44 Median $2,630.27 Typical High $10,232.93 | Professional | None | $1,445.44 | $2,630.27 | $10,232.93 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,344.23 Typical High $10,964.78 | Facility | None | $467.74 | $2,344.23 | $10,964.78 |
United Setting Professional Modifier None Typical Low $1,288.25 Median $2,238.72 Typical High $3,019.95 | Professional | None | $1,288.25 | $2,238.72 | $3,019.95 |
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 $602.56 Median $707.95 Typical High $741.31 | Professional | 52 · Reduced service | $602.56 | $707.95 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $288.40 Typical High $295.12 | Professional | 53 · Discontinued | $239.88 | $288.40 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $912.01 Median $1,071.52 Typical High $1,122.02 | Professional | 54 · Surgery only | $912.01 | $1,071.52 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $213.80 Typical High $223.87 | Professional | 55 · Aftercare only | $181.97 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $144.54 Typical High $147.91 | Professional | 56 · Pre-op care only | $120.23 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $851.14 Median $1,000.00 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $851.14 | $1,000.00 | $1,047.13 |
Where Missouri sits
The same service costs 5.9 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· 20th of 51
$1,862
AK $5,888TX $1,000
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.