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 $660.69 Median $5,248.07 Typical High $13,803.84 | Facility | None | $660.69 | $5,248.07 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $707.95 | Professional | None | $446.68 | $549.54 | $707.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $933.25 | Professional | None | $616.60 | $724.44 | $933.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $114.82 Typical High $147.91 | Professional | 80 · Assistant surgeon | $97.72 | $114.82 | $147.91 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $102.33 Typical High $128.82 | Professional | AS · PA/NP assist | $85.11 | $102.33 | $128.82 |
BCBS Kansas City Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $831.76 | Professional | None | $501.19 | $660.69 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $2,754.23 Typical High $5,248.07 | Facility | None | $1,202.26 | $2,754.23 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $707.95 Typical High $1,258.93 | Professional | None | $436.52 | $707.95 | $1,258.93 |
Medica Setting Facility Modifier None Typical Low $851.14 Median $2,754.23 Typical High $26,302.68 | Facility | None | $851.14 | $2,754.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $776.25 Median $5,754.40 Typical High $5,754.40 | Professional | None | $776.25 | $5,754.40 | $5,754.40 |
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 $537.03 Median $794.33 Typical High $1,148.15 | Professional | None | $537.03 | $794.33 | $1,148.15 |
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 $223.87 Median $269.15 Typical High $338.84 | Professional | 52 · Reduced service | $223.87 | $269.15 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $107.15 Typical High $134.90 | Professional | 53 · Discontinued | $89.13 | $107.15 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $398.11 Typical High $512.86 | Professional | 54 · Surgery only | $338.84 | $398.11 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $79.43 Typical High $102.33 | Professional | 55 · Aftercare only | $67.61 | $79.43 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $53.70 Typical High $67.61 | Professional | 56 · Pre-op care only | $44.67 | $53.70 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $371.54 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $316.23 | $371.54 | $478.63 |
Where Missouri sits
The same service costs 6.2 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
$776
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.