How much rates vary
Facilitymedian $3,890 · 10th to 90th $1,288 to $10,715Professionalmedian $1,698 · 10th to 90th $1,230 to $3,890
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 $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,621.81 | Professional | None | $1,096.48 | $1,318.26 | $1,621.81 |
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 $1,230.27 Median $1,621.81 Typical High $2,290.87 | Professional | None | $1,230.27 | $1,621.81 | $2,290.87 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $1,023.29 Typical High $1,445.44 | Professional | 62 · Two surgeons | $776.25 | $1,023.29 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $199.53 Median $257.04 Typical High $363.08 | Professional | 80 · Assistant surgeon | $199.53 | $257.04 | $363.08 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $229.09 Typical High $316.23 | Professional | AS · PA/NP assist | $173.78 | $229.09 | $316.23 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $1,737.80 | Professional | None | $1,202.26 | $1,288.25 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $4,073.80 Typical High $6,025.60 | Facility | None | $645.65 | $4,073.80 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $2,570.40 | Professional | None | $1,096.48 | $1,445.44 | $2,570.40 |
Medica Setting Facility Modifier None Typical Low $1,479.11 Median $4,365.16 Typical High $26,302.68 | Facility | None | $1,479.11 | $4,365.16 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $1,380.38 Median $2,454.71 Typical High $9,772.37 | Professional | None | $1,380.38 | $2,454.71 | $9,772.37 |
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 $1,202.26 Median $2,137.96 Typical High $2,754.23 | Professional | None | $1,202.26 | $2,137.96 | $2,754.23 |
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 $549.54 Median $660.69 Typical High $676.08 | Professional | 52 · Reduced service | $549.54 | $660.69 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $263.03 Typical High $269.15 | Professional | 53 · Discontinued | $218.78 | $263.03 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $977.24 Typical High $1,023.29 | Professional | 54 · Surgery only | $831.76 | $977.24 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $194.98 Typical High $204.17 | Professional | 55 · Aftercare only | $165.96 | $194.98 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $131.83 Typical High $134.90 | Professional | 56 · Pre-op care only | $109.65 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $912.01 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $776.25 | $912.01 | $954.99 |
Where Missouri sits
The same service costs 11.0 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· 23rd of 51
$1,905
AK $5,370TX $490
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.