How much rates vary
Facilitymedian $2,884 · 10th to 90th $1,122 to $7,762Professionalmedian $1,096 · 10th to 90th $871 to $7,413
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 $2,089.30 Median $5,623.41 Typical High $8,709.64 | Facility | None | $2,089.30 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $1,513.56 | Professional | None | $1,023.29 | $1,096.48 | $1,513.56 |
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 $933.25 Median $1,096.48 Typical High $1,621.81 | Professional | None | $933.25 | $1,096.48 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,380.38 Median $1,621.81 Typical High $2,454.71 | Professional | 50 · Both sides | $1,380.38 | $1,621.81 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $147.91 Median $173.78 Typical High $263.03 | Professional | 80 · Assistant surgeon | $147.91 | $173.78 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $151.36 Typical High $229.09 | Professional | AS · PA/NP assist | $128.82 | $151.36 | $229.09 |
BCBS Kansas City Setting Professional Modifier None Typical Low $851.14 Median $891.25 Typical High $1,230.27 | Professional | None | $851.14 | $891.25 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $1,621.81 Typical High $3,801.89 | Facility | None | $912.01 | $1,621.81 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $1,698.24 | Professional | None | $912.01 | $977.24 | $1,698.24 |
Medica Setting Facility Modifier None Typical Low $1,023.29 Median $2,754.23 Typical High $26,302.68 | Facility | None | $1,023.29 | $2,754.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $831.76 Median $1,737.80 Typical High $7,413.10 | Professional | None | $831.76 | $1,737.80 | $7,413.10 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,096.48 Typical High $1,819.70 | Professional | None | $831.76 | $1,096.48 | $1,819.70 |
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 $512.86 Median $549.54 Typical High $602.56 | Professional | 52 · Reduced service | $512.86 | $549.54 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $218.78 Typical High $239.88 | Professional | 53 · Discontinued | $204.17 | $218.78 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $812.83 Typical High $891.25 | Professional | 54 · Surgery only | $758.58 | $812.83 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $165.96 Typical High $177.83 | Professional | 55 · Aftercare only | $151.36 | $165.96 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $109.65 Typical High $120.23 | Professional | 56 · Pre-op care only | $102.33 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $758.58 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $707.95 | $758.58 | $831.76 |
Where Missouri sits
The same service costs 7.2 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· 31st of 51
$1,175
AK $3,981UT $550
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.