How much rates vary
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 $1,778.28 Median $5,623.41 Typical High $10,715.19 | Facility | None | $1,778.28 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $1,122.02 Typical High $1,513.56 | Professional | None | $758.58 | $1,122.02 | $1,513.56 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $1,778.28 | Professional | None | $1,096.48 | $1,258.93 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $177.83 Median $204.17 Typical High $288.40 | Professional | 80 · Assistant surgeon | $177.83 | $204.17 | $288.40 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $177.83 Typical High $251.19 | Professional | AS · PA/NP assist | $154.88 | $177.83 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $4,570.88 Typical High $6,760.83 | Facility | None | $707.95 | $4,570.88 | $6,760.83 |
Cigna 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 |
Medica Setting Facility Modifier None Typical Low $1,148.15 Median $4,466.84 Typical High $25,118.86 | Facility | None | $1,148.15 | $4,466.84 | $25,118.86 |
Medica Setting Professional Modifier None Typical Low $1,202.26 Median $1,905.46 Typical High $8,709.64 | Professional | None | $1,202.26 | $1,905.46 | $8,709.64 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,570.88 Typical High $13,489.63 | Facility | None | $977.24 | $4,570.88 | $13,489.63 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,621.81 Typical High $2,398.83 | Professional | None | $1,096.48 | $1,621.81 | $2,398.83 |
5 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 $380.19 Median $562.34 Typical High $741.31 | Professional | 52 · Reduced service | $380.19 | $562.34 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $223.87 Typical High $302.00 | Professional | 53 · Discontinued | $151.36 | $223.87 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $851.14 Typical High $1,122.02 | Professional | 54 · Surgery only | $575.44 | $851.14 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $169.82 Typical High $223.87 | Professional | 55 · Aftercare only | $114.82 | $169.82 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $112.20 Typical High $151.36 | Professional | 56 · Pre-op care only | $75.86 | $112.20 | $151.36 |
Where Missouri sits
The same service costs 5.9 times more in Texas than in Kentucky. 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· 39th of 51
$1,479
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.