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 $446.68 Median $537.03 Typical High $630.96 | Professional | None | $446.68 | $537.03 | $630.96 |
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 $741.31 Typical High $977.24 | Professional | None | $549.54 | $741.31 | $977.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $87.10 Median $117.49 Typical High $158.49 | Professional | 80 · Assistant surgeon | $87.10 | $117.49 | $158.49 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $77.62 Median $104.71 Typical High $138.04 | Professional | AS · PA/NP assist | $77.62 | $104.71 | $138.04 |
BCBS Kansas City Setting Professional Modifier None Typical Low $489.78 Median $524.81 Typical High $724.44 | Professional | None | $489.78 | $524.81 | $724.44 |
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 $446.68 Median $602.56 Typical High $1,148.15 | Professional | None | $446.68 | $602.56 | $1,148.15 |
Medica Setting Facility Modifier None Typical Low $851.14 Median $5,011.87 Typical High $16,218.10 | Facility | None | $851.14 | $5,011.87 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $549.54 Median $1,000.00 Typical High $6,309.57 | Professional | None | $549.54 | $1,000.00 | $6,309.57 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,570.88 Typical High $12,302.69 | Facility | None | $977.24 | $4,570.88 | $12,302.69 |
United Setting Professional Modifier None Typical Low $478.63 Median $707.95 Typical High $1,096.48 | Professional | None | $478.63 | $707.95 | $1,096.48 |
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 $223.87 Median $269.15 Typical High $295.12 | Professional | 52 · Reduced service | $223.87 | $269.15 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $107.15 Typical High $117.49 | Professional | 53 · Discontinued | $89.13 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $407.38 Typical High $446.68 | Professional | 54 · Surgery only | $338.84 | $407.38 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $81.28 Typical High $89.13 | Professional | 55 · Aftercare only | $67.61 | $81.28 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $53.70 Typical High $58.88 | Professional | 56 · Pre-op care only | $44.67 | $53.70 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $380.19 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $316.23 | $380.19 | $416.87 |
Where Missouri sits
The same service costs 6.6 times more in Alaska than in Utah. 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· 30th 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.