How much rates vary
Facilitymedian $3,715 · 10th to 90th $1,288 to $10,965Professionalmedian $1,413 · 10th to 90th $977 to $3,311
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 $1,698.24 Median $5,623.41 Typical High $10,715.19 | Facility | None | $1,698.24 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,318.26 | Professional | None | $912.01 | $1,071.52 | $1,318.26 |
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 $1,122.02 Median $1,348.96 Typical High $1,862.09 | Professional | None | $1,122.02 | $1,348.96 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $851.14 Typical High $1,174.90 | Professional | 62 · Two surgeons | $691.83 | $851.14 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $218.78 Typical High $302.00 | Professional | 80 · Assistant surgeon | $177.83 | $218.78 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $190.55 Typical High $263.03 | Professional | AS · PA/NP assist | $154.88 | $190.55 | $263.03 |
BCBS Kansas City Setting Professional Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,412.54 | Professional | None | $954.99 | $1,023.29 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,311.31 Typical High $3,981.07 | Facility | None | $758.58 | $3,311.31 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $1,202.26 Typical High $2,137.96 | Professional | None | $912.01 | $1,202.26 | $2,137.96 |
Medica Setting Facility Modifier None Typical Low $1,258.93 Median $4,365.16 Typical High $26,302.68 | Facility | None | $1,258.93 | $4,365.16 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $1,148.15 Median $1,995.26 Typical High $8,128.31 | Professional | None | $1,148.15 | $1,995.26 | $8,128.31 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,981.07 | $8,709.64 |
United Setting Professional Modifier None Typical Low $954.99 Median $1,778.28 Typical High $2,238.72 | Professional | None | $954.99 | $1,778.28 | $2,238.72 |
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 $537.03 Typical High $562.34 | Professional | 52 · Reduced service | $457.09 | $537.03 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $213.80 Typical High $223.87 | Professional | 53 · Discontinued | $181.97 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $794.33 Typical High $831.76 | Professional | 54 · Surgery only | $676.08 | $794.33 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $158.49 Typical High $169.82 | Professional | 55 · Aftercare only | $134.90 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $107.15 Typical High $112.20 | Professional | 56 · Pre-op care only | $91.20 | $107.15 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $741.31 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $630.96 | $741.31 | $776.25 |
Where Missouri sits
The same service costs 6.3 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· 23rd of 51
$1,585
AK $4,365UT $692
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.