How much rates vary
Facilitymedian $3,802 · 10th to 90th $1,259 to $10,965Professionalmedian $1,349 · 10th to 90th $977 to $3,236
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 $870.96 Median $1,047.13 Typical High $1,318.26 | Professional | None | $870.96 | $1,047.13 | $1,318.26 |
Ambetter Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
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 $1,023.29 Median $1,288.25 Typical High $1,819.70 | Professional | None | $1,023.29 | $1,288.25 | $1,819.70 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $812.83 Typical High $1,148.15 | Professional | 62 · Two surgeons | $645.65 | $812.83 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $162.18 Median $204.17 Typical High $288.40 | Professional | 80 · Assistant surgeon | $162.18 | $204.17 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $141.25 Median $177.83 Typical High $251.19 | Professional | AS · PA/NP assist | $141.25 | $177.83 | $251.19 |
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 $602.56 Median $6,456.54 Typical High $9,549.93 | Facility | None | $602.56 | $6,456.54 | $9,549.93 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $2,041.74 | Professional | None | $870.96 | $1,148.15 | $2,041.74 |
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 $1,122.02 Median $1,949.84 Typical High $7,762.47 | Professional | None | $1,122.02 | $1,949.84 | $7,762.47 |
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 $1,698.24 Typical High $2,187.76 | Professional | None | $954.99 | $1,698.24 | $2,187.76 |
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 $436.52 Median $524.81 Typical High $537.03 | Professional | 52 · Reduced service | $436.52 | $524.81 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $208.93 Typical High $213.80 | Professional | 53 · Discontinued | $173.78 | $208.93 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $776.25 Typical High $812.83 | Professional | 54 · Surgery only | $660.69 | $776.25 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $154.88 Typical High $162.18 | Professional | 55 · Aftercare only | $131.83 | $154.88 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $104.71 Typical High $107.15 | Professional | 56 · Pre-op care only | $87.10 | $104.71 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $724.44 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $616.60 | $724.44 | $758.58 |
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· 23rd of 51
$1,514
AK $4,266UT $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.