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 $1,548.82 Median $3,981.07 Typical High $7,762.47 | Facility | None | $1,548.82 | $3,981.07 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $758.58 | Professional | None | $537.03 | $645.65 | $758.58 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $912.01 | Professional | None | $549.54 | $660.69 | $912.01 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $104.71 Typical High $147.91 | Professional | 80 · Assistant surgeon | $87.10 | $104.71 | $147.91 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $75.86 Median $91.20 Typical High $128.82 | Professional | AS · PA/NP assist | $75.86 | $91.20 | $128.82 |
BCBS Kansas City Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $831.76 | Professional | None | $588.84 | $645.65 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,122.02 Typical High $2,187.76 | Facility | None | $602.56 | $1,122.02 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $1,288.25 | Professional | None | $537.03 | $676.08 | $1,288.25 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $1,819.70 Typical High $16,218.10 | Facility | None | $588.84 | $1,819.70 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $588.84 Median $1,047.13 Typical High $4,897.79 | Professional | None | $588.84 | $1,047.13 | $4,897.79 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,235.94 | Facility | None | $562.34 | $1,513.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $562.34 Median $776.25 Typical High $1,258.93 | Professional | None | $562.34 | $776.25 | $1,258.93 |
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 $269.15 Median $323.59 Typical High $354.81 | Professional | 52 · Reduced service | $269.15 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $128.82 Typical High $141.25 | Professional | 53 · Discontinued | $107.15 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $478.63 Typical High $524.81 | Professional | 54 · Surgery only | $398.11 | $478.63 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $95.50 Typical High $107.15 | Professional | 55 · Aftercare only | $81.28 | $95.50 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $64.57 Typical High $70.79 | Professional | 56 · Pre-op care only | $53.70 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $446.68 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $371.54 | $446.68 | $489.78 |
Where Missouri sits
The same service costs 7.4 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· 33rd of 51
$708
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.