How much rates vary
Facilitymedian $3,467 · 10th to 90th $1,413 to $8,710Professionalmedian $2,291 · 10th to 90th $1,820 to $4,571
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 $1,659.59 Median $1,659.59 Typical High $2,754.23 | Professional | None | $1,659.59 | $1,659.59 | $2,754.23 |
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 $1,862.09 Median $2,290.87 Typical High $3,467.37 | Professional | None | $1,862.09 | $2,290.87 | $3,467.37 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,754.23 Median $3,388.44 Typical High $5,128.61 | Professional | 50 · Both sides | $2,754.23 | $3,388.44 | $5,128.61 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $295.12 Median $363.08 Typical High $549.54 | Professional | 80 · Assistant surgeon | $295.12 | $363.08 | $549.54 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $257.04 Median $323.59 Typical High $478.63 | Professional | AS · PA/NP assist | $257.04 | $323.59 | $478.63 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,621.81 Median $1,819.70 Typical High $2,511.89 | Professional | None | $1,621.81 | $1,819.70 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,951.21 Typical High $4,365.16 | Facility | None | $741.31 | $2,951.21 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $2,137.96 Typical High $4,168.69 | Professional | None | $1,737.80 | $2,137.96 | $4,168.69 |
Medica Setting Facility Modifier None Typical Low $1,513.56 Median $2,951.21 Typical High $13,803.84 | Facility | None | $1,513.56 | $2,951.21 | $13,803.84 |
Medica Setting Professional Modifier None Typical Low $1,905.46 Median $4,168.69 Typical High $14,125.38 | Professional | None | $1,905.46 | $4,168.69 | $14,125.38 |
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 $1,905.46 Median $2,570.40 Typical High $4,265.80 | Professional | None | $1,905.46 | $2,570.40 | $4,265.80 |
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 $831.76 Median $831.76 Typical High $1,000.00 | Professional | 52 · Reduced service | $831.76 | $831.76 | $1,000.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $407.38 | Professional | 53 · Discontinued | $331.13 | $331.13 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,258.93 Typical High $1,513.56 | Professional | 54 · Surgery only | $1,230.27 | $1,258.93 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $251.19 Typical High $302.00 | Professional | 55 · Aftercare only | $245.47 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $199.53 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,148.15 Median $1,174.90 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $1,148.15 | $1,174.90 | $1,412.54 |
Where Missouri sits
The same service costs 6.9 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· 31st of 51
$2,344
AK $7,586TX $1,096
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.