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 $1,148.15 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,148.15 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $794.33 | Professional | None | $575.44 | $676.08 | $794.33 |
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 $575.44 Median $660.69 Typical High $1,023.29 | Professional | None | $575.44 | $660.69 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $93.33 Median $104.71 Typical High $165.96 | Professional | 80 · Assistant surgeon | $93.33 | $104.71 | $165.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $81.28 Median $91.20 Typical High $144.54 | Professional | AS · PA/NP assist | $81.28 | $91.20 | $144.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $933.25 | Professional | None | $645.65 | $707.95 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,659.59 Typical High $2,344.23 | Facility | None | $446.68 | $1,659.59 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $691.83 Typical High $1,230.27 | Professional | None | $562.34 | $691.83 | $1,230.27 |
Medica Setting Facility Modifier None Typical Low $630.96 Median $1,862.09 Typical High $12,022.64 | Facility | None | $630.96 | $1,862.09 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $1,096.48 Typical High $5,011.87 | Professional | None | $645.65 | $1,096.48 | $5,011.87 |
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 $1,348.96 | Professional | None | $562.34 | $776.25 | $1,348.96 |
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 $288.40 Median $338.84 Typical High $380.19 | Professional | 52 · Reduced service | $288.40 | $338.84 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $134.90 Typical High $151.36 | Professional | 53 · Discontinued | $114.82 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $501.19 Typical High $575.44 | Professional | 54 · Surgery only | $436.52 | $501.19 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $100.00 Typical High $114.82 | Professional | 55 · Aftercare only | $87.10 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $67.61 Typical High $75.86 | Professional | 56 · Pre-op care only | $57.54 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $467.74 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $407.38 | $467.74 | $537.03 |
Where Missouri sits
The same service costs 7.8 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· 34th of 51
$741
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.