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 $724.44 Median $851.14 Typical High $1,071.52 | Professional | None | $724.44 | $851.14 | $1,071.52 |
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 $870.96 Median $1,047.13 Typical High $1,412.54 | Professional | None | $870.96 | $1,047.13 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $141.25 Median $165.96 Typical High $229.09 | Professional | 80 · Assistant surgeon | $141.25 | $165.96 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $123.03 Median $147.91 Typical High $199.53 | Professional | AS · PA/NP assist | $123.03 | $147.91 | $199.53 |
BCBS Kansas City Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $1,071.52 | Professional | None | $776.25 | $831.76 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $5,248.07 Typical High $7,244.36 | Facility | None | $1,202.26 | $5,248.07 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,698.24 | Professional | None | $707.95 | $954.99 | $1,698.24 |
Medica Setting Facility Modifier None Typical Low $1,122.02 Median $4,365.16 Typical High $26,302.68 | Facility | None | $1,122.02 | $4,365.16 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $1,412.54 Typical High $13,182.57 | Professional | None | $851.14 | $1,412.54 | $13,182.57 |
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 $758.58 Median $1,047.13 Typical High $1,698.24 | Professional | None | $758.58 | $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 $354.81 Median $426.58 Typical High $467.74 | Professional | 52 · Reduced service | $354.81 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $169.82 Typical High $190.55 | Professional | 53 · Discontinued | $144.54 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $630.96 Typical High $707.95 | Professional | 54 · Surgery only | $537.03 | $630.96 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $125.89 Typical High $141.25 | Professional | 55 · Aftercare only | $107.15 | $125.89 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $85.11 Typical High $93.33 | Professional | 56 · Pre-op care only | $72.44 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $588.84 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $501.19 | $588.84 | $660.69 |
Where Missouri sits
The same service costs 17.8 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· 26th of 51
$1,122
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.