How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,318 to $10,715Professionalmedian $1,905 · 10th to 90th $1,349 to $4,169
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 $1,202.26 Median $1,412.54 Typical High $1,737.80 | Professional | None | $1,202.26 | $1,412.54 | $1,737.80 |
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 $1,412.54 Median $1,819.70 Typical High $2,454.71 | Professional | None | $1,412.54 | $1,819.70 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $870.96 Median $1,148.15 Typical High $1,548.82 | Professional | 62 · Two surgeons | $870.96 | $1,148.15 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $223.87 Median $295.12 Typical High $398.11 | Professional | 80 · Assistant surgeon | $223.87 | $295.12 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $194.98 Median $257.04 Typical High $346.74 | Professional | AS · PA/NP assist | $194.98 | $257.04 | $346.74 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,288.25 Median $1,380.38 Typical High $1,905.46 | Professional | None | $1,288.25 | $1,380.38 | $1,905.46 |
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 $1,202.26 Median $1,584.89 Typical High $2,884.03 | Professional | None | $1,202.26 | $1,584.89 | $2,884.03 |
Medica Setting Facility Modifier None Typical Low $1,479.11 Median $4,466.84 Typical High $26,302.68 | Facility | None | $1,479.11 | $4,466.84 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $1,479.11 Median $2,754.23 Typical High $10,964.78 | Professional | None | $1,479.11 | $2,754.23 | $10,964.78 |
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 $1,288.25 Median $2,398.83 Typical High $2,951.21 | Professional | None | $1,288.25 | $2,398.83 | $2,951.21 |
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 $588.84 Median $707.95 Typical High $724.44 | Professional | 52 · Reduced service | $588.84 | $707.95 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $281.84 Typical High $295.12 | Professional | 53 · Discontinued | $239.88 | $281.84 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $1,071.52 Typical High $1,096.48 | Professional | 54 · Surgery only | $891.25 | $1,071.52 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $213.80 Typical High $218.78 | Professional | 55 · Aftercare only | $177.83 | $213.80 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $141.25 Typical High $147.91 | Professional | 56 · Pre-op care only | $120.23 | $141.25 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $1,000.00 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $831.76 | $1,000.00 | $1,023.29 |
Where Missouri sits
The same service costs 24.5 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· 22nd of 51
$2,042
AK $5,754TX $234
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.