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 $1,698.24 Median $5,754.40 Typical High $13,182.57 | Facility | None | $1,698.24 | $5,754.40 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $977.24 Typical High $1,148.15 | Professional | None | $812.83 | $977.24 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,981.07 Typical High $10,471.29 | Facility | None | $1,412.54 | $3,981.07 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $954.99 Median $1,230.27 Typical High $1,659.59 | Professional | None | $954.99 | $1,230.27 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,445.44 Median $1,862.09 Typical High $2,454.71 | Professional | 50 · Both sides | $1,445.44 | $1,862.09 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $602.56 Median $776.25 Typical High $1,047.13 | Professional | 62 · Two surgeons | $602.56 | $776.25 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $154.88 Median $194.98 Typical High $263.03 | Professional | 80 · Assistant surgeon | $154.88 | $194.98 | $263.03 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $134.90 Median $173.78 Typical High $229.09 | Professional | AS · PA/NP assist | $134.90 | $173.78 | $229.09 |
BCBS Kansas City Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $1,258.93 | Professional | None | $891.25 | $954.99 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $4,168.69 Typical High $15,488.17 | Facility | None | $851.14 | $4,168.69 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,047.13 Typical High $1,995.26 | Professional | None | $812.83 | $1,047.13 | $1,995.26 |
Medica Setting Facility Modifier None Typical Low $1,202.26 Median $4,365.16 Typical High $26,302.68 | Facility | None | $1,202.26 | $4,365.16 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $977.24 Median $1,621.81 Typical High $7,079.46 | Professional | None | $977.24 | $1,621.81 | $7,079.46 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,981.07 | $8,709.64 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,230.27 Typical High $1,949.84 | Professional | None | $851.14 | $1,230.27 | $1,949.84 |
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 $407.38 Median $489.78 Typical High $537.03 | Professional | 52 · Reduced service | $407.38 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $194.98 Typical High $213.80 | Professional | 53 · Discontinued | $162.18 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $741.31 Typical High $812.83 | Professional | 54 · Surgery only | $616.60 | $741.31 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $147.91 Typical High $162.18 | Professional | 55 · Aftercare only | $123.03 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $97.72 Typical High $107.15 | Professional | 56 · Pre-op care only | $81.28 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $691.83 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $575.44 | $691.83 | $758.58 |
Where Missouri sits
The same service costs 7.9 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· 25th of 51
$1,318
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.