How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,259 to $10,715Professionalmedian $1,479 · 10th to 90th $1,047 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 $1,548.82 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 $933.25 Median $1,122.02 Typical High $1,412.54 | Professional | None | $933.25 | $1,122.02 | $1,412.54 |
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 $1,096.48 Median $1,445.44 Typical High $1,949.84 | Professional | None | $1,096.48 | $1,445.44 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $229.09 Typical High $309.03 | Professional | 80 · Assistant surgeon | $173.78 | $229.09 | $309.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $151.36 Median $199.53 Typical High $269.15 | Professional | AS · PA/NP assist | $151.36 | $199.53 | $269.15 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $1,479.11 | Professional | None | $1,023.29 | $1,096.48 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,187.76 Typical High $3,162.28 | Facility | None | $602.56 | $2,187.76 | $3,162.28 |
Cigna Setting Professional Modifier None Typical Low $933.25 Median $1,230.27 Typical High $2,187.76 | Professional | None | $933.25 | $1,230.27 | $2,187.76 |
Medica Setting Facility Modifier None Typical Low $1,258.93 Median $4,365.16 Typical High $18,620.87 | Facility | None | $1,258.93 | $4,365.16 | $18,620.87 |
Medica Setting Professional Modifier None Typical Low $1,202.26 Median $2,089.30 Typical High $8,128.31 | Professional | None | $1,202.26 | $2,089.30 | $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 $1,000.00 Median $1,819.70 Typical High $2,344.23 | Professional | None | $1,000.00 | $1,819.70 | $2,344.23 |
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 $467.74 Median $549.54 Typical High $575.44 | Professional | 52 · Reduced service | $467.74 | $549.54 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $223.87 Typical High $229.09 | Professional | 53 · Discontinued | $186.21 | $223.87 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $831.76 Typical High $870.96 | Professional | 54 · Surgery only | $707.95 | $831.76 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $165.96 Typical High $173.78 | Professional | 55 · Aftercare only | $141.25 | $165.96 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $112.20 Typical High $114.82 | Professional | 56 · Pre-op care only | $93.33 | $112.20 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $776.25 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $660.69 | $776.25 | $812.83 |
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· 22nd of 51
$1,660
AK $4,571UT $741
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.