How much rates vary
Facilitymedian $3,981 · 10th to 90th $1,288 to $10,715Professionalmedian $1,660 · 10th to 90th $1,175 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 $1,047.13 Median $1,258.93 Typical High $1,584.89 | Professional | None | $1,047.13 | $1,258.93 | $1,584.89 |
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 $1,548.82 Typical High $2,187.76 | Professional | None | $1,230.27 | $1,548.82 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $776.25 Median $977.24 Typical High $1,380.38 | Professional | 62 · Two surgeons | $776.25 | $977.24 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $194.98 Median $251.19 Typical High $346.74 | Professional | 80 · Assistant surgeon | $194.98 | $251.19 | $346.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $173.78 Median $218.78 Typical High $309.03 | Professional | AS · PA/NP assist | $173.78 | $218.78 | $309.03 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,148.15 Median $1,230.27 Typical High $1,698.24 | Professional | None | $1,148.15 | $1,230.27 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $5,248.07 Typical High $7,585.78 | Facility | None | $645.65 | $5,248.07 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,380.38 Typical High $2,454.71 | Professional | None | $1,047.13 | $1,380.38 | $2,454.71 |
Medica Setting Facility Modifier None Typical Low $1,412.54 Median $4,365.16 Typical High $26,302.68 | Facility | None | $1,412.54 | $4,365.16 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $1,348.96 Median $2,344.23 Typical High $9,332.54 | Professional | None | $1,348.96 | $2,344.23 | $9,332.54 |
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 $1,148.15 Median $2,041.74 Typical High $2,630.27 | Professional | None | $1,148.15 | $2,041.74 | $2,630.27 |
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 $524.81 Median $630.96 Typical High $645.65 | Professional | 52 · Reduced service | $524.81 | $630.96 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $251.19 Typical High $257.04 | Professional | 53 · Discontinued | $208.93 | $251.19 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $933.25 Typical High $977.24 | Professional | 54 · Surgery only | $794.33 | $933.25 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $186.21 Typical High $194.98 | Professional | 55 · Aftercare only | $158.49 | $186.21 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $125.89 Typical High $128.82 | Professional | 56 · Pre-op care only | $104.71 | $125.89 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $870.96 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $741.31 | $870.96 | $912.01 |
Where Missouri sits
The same service costs 7.4 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
$1,820
AK $5,129TX $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.