How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,096 to $7,079Professionalmedian $1,549 · 10th to 90th $1,096 to $3,548
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 $1,548.82 Median $3,981.07 Typical High $7,762.47 | Facility | None | $1,548.82 | $3,981.07 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,445.44 | Professional | None | $977.24 | $1,174.90 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,288.25 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,995.26 | Professional | None | $1,174.90 | $1,380.38 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,778.28 Median $2,089.30 Typical High $2,951.21 | Professional | 50 · Both sides | $1,778.28 | $2,089.30 | $2,951.21 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $741.31 Median $870.96 Typical High $1,230.27 | Professional | 62 · Two surgeons | $741.31 | $870.96 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $223.87 Typical High $316.23 | Professional | 80 · Assistant surgeon | $186.21 | $223.87 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $165.96 Median $194.98 Typical High $275.42 | Professional | AS · PA/NP assist | $165.96 | $194.98 | $275.42 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,513.56 | Professional | None | $1,071.52 | $1,148.15 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,230.27 Typical High $2,187.76 | Facility | None | $602.56 | $1,230.27 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $977.24 Median $1,288.25 Typical High $2,238.72 | Professional | None | $977.24 | $1,288.25 | $2,238.72 |
Medica Setting Facility Modifier None Typical Low $1,174.90 Median $3,801.89 Typical High $16,218.10 | Facility | None | $1,174.90 | $3,801.89 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $1,258.93 Median $2,187.76 Typical High $8,709.64 | Professional | None | $1,258.93 | $2,187.76 | $8,709.64 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,760.83 | Facility | None | $1,000.00 | $3,467.37 | $6,760.83 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,737.80 Typical High $2,454.71 | Professional | None | $1,047.13 | $1,737.80 | $2,454.71 |
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 $489.78 Median $588.84 Typical High $602.56 | Professional | 52 · Reduced service | $489.78 | $588.84 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $234.42 Typical High $239.88 | Professional | 53 · Discontinued | $194.98 | $234.42 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $870.96 Typical High $912.01 | Professional | 54 · Surgery only | $741.31 | $870.96 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $173.78 Typical High $181.97 | Professional | 55 · Aftercare only | $147.91 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $117.49 Typical High $120.23 | Professional | 56 · Pre-op care only | $97.72 | $117.49 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $812.83 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $691.83 | $812.83 | $851.14 |
Where Missouri sits
The same service costs 6.2 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· 21st of 51
$1,622
AK $4,786UT $776
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.