How much rates vary
Facilitymedian $3,236 · 10th to 90th $1,148 to $8,913Professionalmedian $1,122 · 10th to 90th $871 to $7,244
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 $954.99 Median $1,023.29 Typical High $1,412.54 | Professional | None | $954.99 | $1,023.29 | $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 $912.01 Median $1,258.93 Typical High $1,621.81 | Professional | None | $912.01 | $1,258.93 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,905.46 Typical High $2,454.71 | Professional | 50 · Both sides | $1,348.96 | $1,905.46 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $794.33 Typical High $1,023.29 | Professional | 62 · Two surgeons | $575.44 | $794.33 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $204.17 Typical High $263.03 | Professional | 80 · Assistant surgeon | $144.54 | $204.17 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $177.83 Typical High $229.09 | Professional | AS · PA/NP assist | $125.89 | $177.83 | $229.09 |
BCBS Kansas City Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $1,230.27 | Professional | None | $776.25 | $831.76 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,137.96 Typical High $2,691.53 | Facility | None | $645.65 | $2,137.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $933.25 Typical High $1,659.59 | Professional | None | $851.14 | $933.25 | $1,659.59 |
Medica Setting Facility Modifier None Typical Low $1,071.52 Median $3,801.89 Typical High $26,302.68 | Facility | None | $1,071.52 | $3,801.89 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $870.96 Median $1,659.59 Typical High $7,244.36 | Professional | None | $870.96 | $1,659.59 | $7,244.36 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,467.37 | $6,918.31 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,698.24 | Professional | None | $851.14 | $1,047.13 | $1,698.24 |
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 $512.86 Typical High $549.54 | Professional | 52 · Reduced service | $467.74 | $512.86 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $204.17 Typical High $218.78 | Professional | 53 · Discontinued | $190.55 | $204.17 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $776.25 Typical High $831.76 | Professional | 54 · Surgery only | $707.95 | $776.25 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $154.88 Typical High $165.96 | Professional | 55 · Aftercare only | $141.25 | $154.88 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $102.33 Typical High $109.65 | Professional | 56 · Pre-op care only | $95.50 | $102.33 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $724.44 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $660.69 | $724.44 | $776.25 |
Where Missouri sits
The same service costs 3.1 times more in Wisconsin than in Florida. 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.
Physician feeFacility fee
WI $8,254FL $2,626
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.