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 $478.63 Median $4,897.79 Typical High $7,762.47 | Facility | None | $478.63 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $588.84 | Professional | None | $416.87 | $457.09 | $588.84 |
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 $331.13 Median $549.54 Typical High $851.14 | Professional | None | $331.13 | $549.54 | $851.14 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $208.93 Median $346.74 Typical High $537.03 | Professional | 62 · Two surgeons | $208.93 | $346.74 | $537.03 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $54.95 Median $89.13 Typical High $134.90 | Professional | 80 · Assistant surgeon | $54.95 | $89.13 | $134.90 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $46.77 Median $77.62 Typical High $120.23 | Professional | AS · PA/NP assist | $46.77 | $77.62 | $120.23 |
BCBS Kansas City Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $588.84 | Professional | None | $371.54 | $407.38 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,951.21 Typical High $4,365.16 | Facility | None | $707.95 | $2,951.21 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $467.74 Typical High $1,023.29 | Professional | None | $380.19 | $467.74 | $1,023.29 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,862.09 Typical High $13,803.84 | Facility | None | $54.95 | $1,862.09 | $13,803.84 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $912.01 Typical High $3,311.31 | Professional | None | $316.23 | $912.01 | $3,311.31 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $309.03 Median $630.96 Typical High $954.99 | Professional | None | $309.03 | $630.96 | $954.99 |
5 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 $204.17 Median $223.87 Typical High $229.09 | Professional | 52 · Reduced service | $204.17 | $223.87 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $91.20 Typical High $91.20 | Professional | 53 · Discontinued | $83.18 | $91.20 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $338.84 Typical High $346.74 | Professional | 54 · Surgery only | $309.03 | $338.84 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $67.61 Typical High $69.18 | Professional | 55 · Aftercare only | $61.66 | $67.61 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $45.71 Typical High $45.71 | Professional | 56 · Pre-op care only | $41.69 | $45.71 | $45.71 |
Where Missouri sits
The same service costs 5.2 times more in Alaska than in Kentucky. 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· 29th of 51
$575
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.