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 $2,454.71 Median $5,623.41 Typical High $13,803.84 | Facility | None | $2,454.71 | $5,623.41 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $933.25 | Professional | None | $630.96 | $741.31 | $933.25 |
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 $707.95 Median $851.14 Typical High $1,202.26 | Professional | None | $707.95 | $851.14 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $134.90 Typical High $190.55 | Professional | 80 · Assistant surgeon | $114.82 | $134.90 | $190.55 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $117.49 Typical High $162.18 | Professional | AS · PA/NP assist | $100.00 | $117.49 | $162.18 |
BCBS Kansas City Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $954.99 | Professional | None | $676.08 | $724.44 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $5,248.07 | Facility | None | $1,202.26 | $3,801.89 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $1,479.11 | Professional | None | $616.60 | $794.33 | $1,479.11 |
Medica Setting Facility Modifier None Typical Low $954.99 Median $2,754.23 Typical High $26,302.68 | Facility | None | $954.99 | $2,754.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $741.31 Median $1,230.27 Typical High $6,309.57 | Professional | None | $741.31 | $1,230.27 | $6,309.57 |
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 $660.69 Median $891.25 Typical High $1,479.11 | Professional | None | $660.69 | $891.25 | $1,479.11 |
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 $316.23 Median $371.54 Typical High $416.87 | Professional | 52 · Reduced service | $316.23 | $371.54 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $147.91 Typical High $165.96 | Professional | 53 · Discontinued | $125.89 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $562.34 Typical High $616.60 | Professional | 54 · Surgery only | $467.74 | $562.34 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $112.20 Typical High $123.03 | Professional | 55 · Aftercare only | $93.33 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $74.13 Typical High $83.18 | Professional | 56 · Pre-op care only | $63.10 | $74.13 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $524.81 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $436.52 | $524.81 | $575.44 |
Where Missouri sits
The same service costs 8.5 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· 30th of 51
$933
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.