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 $2,089.30 Median $5,623.41 Typical High $8,709.64 | Facility | None | $2,089.30 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,047.13 Typical High $2,089.30 | Professional | None | $891.25 | $1,047.13 | $2,089.30 |
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 $954.99 Median $1,096.48 Typical High $1,659.59 | Professional | None | $954.99 | $1,096.48 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $151.36 Median $173.78 Typical High $269.15 | Professional | 80 · Assistant surgeon | $151.36 | $173.78 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $131.83 Median $151.36 Typical High $234.42 | Professional | AS · PA/NP assist | $131.83 | $151.36 | $234.42 |
BCBS Kansas City Setting Professional Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,348.96 | Professional | None | $954.99 | $1,047.13 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $2,089.30 Typical High $3,801.89 | Facility | None | $912.01 | $2,089.30 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $1,949.84 | Professional | None | $870.96 | $1,122.02 | $1,949.84 |
Medica Setting Facility Modifier None Typical Low $645.65 Median $1,862.09 Typical High $26,302.68 | Facility | None | $645.65 | $1,862.09 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $1,000.00 Median $1,737.80 Typical High $7,762.47 | Professional | None | $1,000.00 | $1,737.80 | $7,762.47 |
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 $912.01 Median $1,230.27 Typical High $2,089.30 | Professional | None | $912.01 | $1,230.27 | $2,089.30 |
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 $446.68 Median $524.81 Typical High $588.84 | Professional | 52 · Reduced service | $446.68 | $524.81 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $213.80 Typical High $234.42 | Professional | 53 · Discontinued | $177.83 | $213.80 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $794.33 Typical High $870.96 | Professional | 54 · Surgery only | $660.69 | $794.33 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $158.49 Typical High $173.78 | Professional | 55 · Aftercare only | $131.83 | $158.49 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $104.71 Typical High $117.49 | Professional | 56 · Pre-op care only | $89.13 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $741.31 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $616.60 | $741.31 | $812.83 |
Where Missouri sits
The same service costs 7.6 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
$1,175
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.