How much rates vary
Facilitymedian $2,692 · 10th to 90th $525 to $10,965Professionalmedian $1,259 · 10th to 90th $955 to $3,388
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 $1,348.96 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,348.96 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,122.02 | Professional | None | $912.01 | $1,096.48 | $1,122.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $3,801.89 Typical High $11,481.54 | Facility | None | $1,380.38 | $3,801.89 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $977.24 Median $1,230.27 Typical High $1,778.28 | Professional | None | $977.24 | $1,230.27 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,479.11 Median $1,862.09 Typical High $2,570.40 | Professional | 50 · Both sides | $1,479.11 | $1,862.09 | $2,570.40 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $616.60 Median $776.25 Typical High $1,122.02 | Professional | 62 · Two surgeons | $616.60 | $776.25 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $158.49 Median $199.53 Typical High $275.42 | Professional | 80 · Assistant surgeon | $158.49 | $199.53 | $275.42 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $138.04 Median $173.78 Typical High $239.88 | Professional | AS · PA/NP assist | $138.04 | $173.78 | $239.88 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,096.48 Median $1,174.90 Typical High $1,479.11 | Professional | None | $1,096.48 | $1,174.90 | $1,479.11 |
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 $933.25 Median $1,174.90 Typical High $1,905.46 | Professional | None | $933.25 | $1,174.90 | $1,905.46 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,230.27 Typical High $11,220.18 | Facility | None | $54.95 | $1,230.27 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $1,023.29 Median $1,995.26 Typical High $9,332.54 | Professional | None | $1,023.29 | $1,995.26 | $9,332.54 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,290.87 Typical High $10,964.78 | Facility | None | $467.74 | $2,290.87 | $10,964.78 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,258.93 Typical High $2,290.87 | Professional | None | $954.99 | $1,258.93 | $2,290.87 |
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 $457.09 Median $549.54 Typical High $562.34 | Professional | 52 · Reduced service | $457.09 | $549.54 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $218.78 Typical High $223.87 | Professional | 53 · Discontinued | $181.97 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $812.83 Typical High $851.14 | Professional | 54 · Surgery only | $691.83 | $812.83 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $162.18 Typical High $169.82 | Professional | 55 · Aftercare only | $138.04 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $109.65 Typical High $112.20 | Professional | 56 · Pre-op care only | $91.20 | $109.65 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $758.58 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $645.65 | $758.58 | $794.33 |
Where Missouri sits
The same service costs 21.9 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· 28th of 51
$1,259
AK $4,467TX $204
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.