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 $602.56 Median $645.65 Typical High $1,445.44 | Professional | None | $602.56 | $645.65 | $1,445.44 |
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 $602.56 Median $741.31 Typical High $1,122.02 | Professional | None | $602.56 | $741.31 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $117.49 Typical High $181.97 | Professional | 80 · Assistant surgeon | $95.50 | $117.49 | $181.97 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $102.33 Typical High $158.49 | Professional | AS · PA/NP assist | $85.11 | $102.33 | $158.49 |
BCBS Kansas City Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $912.01 | Professional | None | $588.84 | $645.65 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,951.21 Typical High $4,365.16 | Facility | None | $602.56 | $2,951.21 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $707.95 Typical High $1,445.44 | Professional | None | $602.56 | $707.95 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $870.96 Median $4,073.80 Typical High $16,595.87 | Facility | None | $870.96 | $4,073.80 | $16,595.87 |
Medica Setting Professional Modifier None Typical Low $676.08 Median $1,258.93 Typical High $7,585.78 | Professional | None | $676.08 | $1,258.93 | $7,585.78 |
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 $645.65 Median $870.96 Typical High $1,412.54 | Professional | None | $645.65 | $870.96 | $1,412.54 |
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 $302.00 Median $323.59 Typical High $338.84 | Professional | 52 · Reduced service | $302.00 | $323.59 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $128.82 Typical High $134.90 | Professional | 53 · Discontinued | $120.23 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $489.78 Typical High $512.86 | Professional | 54 · Surgery only | $457.09 | $489.78 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $97.72 Typical High $102.33 | Professional | 55 · Aftercare only | $91.20 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $64.57 Typical High $67.61 | Professional | 56 · Pre-op care only | $60.26 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $457.09 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $426.58 | $457.09 | $478.63 |
Where Missouri sits
The same service costs 8.1 times more in Oklahoma 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· 27th of 51
$891
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.