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 $691.83 Median $812.83 Typical High $1,023.29 | Professional | None | $691.83 | $812.83 | $1,023.29 |
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 $724.44 Median $870.96 Typical High $1,258.93 | Professional | None | $724.44 | $870.96 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $138.04 Typical High $204.17 | Professional | 80 · Assistant surgeon | $114.82 | $138.04 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $102.33 Median $123.03 Typical High $177.83 | Professional | AS · PA/NP assist | $102.33 | $123.03 | $177.83 |
BCBS Kansas City Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $1,096.48 | Professional | None | $776.25 | $831.76 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,995.26 Typical High $2,344.23 | Facility | None | $602.56 | $1,995.26 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,548.82 | Professional | None | $691.83 | $851.14 | $1,548.82 |
Medica Setting Facility Modifier None Typical Low $645.65 Median $1,862.09 Typical High $16,218.10 | Facility | None | $645.65 | $1,862.09 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $776.25 Median $1,318.26 Typical High $6,025.60 | Professional | None | $776.25 | $1,318.26 | $6,025.60 |
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 $691.83 Median $933.25 Typical High $1,621.81 | Professional | None | $691.83 | $933.25 | $1,621.81 |
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 $346.74 Median $407.38 Typical High $457.09 | Professional | 52 · Reduced service | $346.74 | $407.38 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $165.96 Typical High $181.97 | Professional | 53 · Discontinued | $138.04 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $616.60 Typical High $691.83 | Professional | 54 · Surgery only | $524.81 | $616.60 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $123.03 Typical High $138.04 | Professional | 55 · Aftercare only | $104.71 | $123.03 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $81.28 Typical High $91.20 | Professional | 56 · Pre-op care only | $69.18 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $575.44 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $489.78 | $575.44 | $645.65 |
Where Missouri sits
The same service costs 8.3 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· 32nd of 51
$955
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.