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 $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $478.63 Typical High $1,230.27 | Professional | None | $436.52 | $478.63 | $1,230.27 |
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 $512.86 Median $724.44 Typical High $954.99 | Professional | None | $512.86 | $724.44 | $954.99 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $83.18 Median $117.49 Typical High $151.36 | Professional | 80 · Assistant surgeon | $83.18 | $117.49 | $151.36 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $102.33 Typical High $131.83 | Professional | AS · PA/NP assist | $72.44 | $102.33 | $131.83 |
BCBS Kansas City Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $691.83 | Professional | None | $457.09 | $501.19 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $5,011.87 Typical High $7,413.10 | Facility | None | $707.95 | $5,011.87 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $616.60 Typical High $1,258.93 | Professional | None | $457.09 | $616.60 | $1,258.93 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,884.03 Typical High $13,489.63 | Facility | None | $54.95 | $2,884.03 | $13,489.63 |
Medica Setting Professional Modifier None Typical Low $549.54 Median $1,000.00 Typical High $3,388.44 | Professional | None | $549.54 | $1,000.00 | $3,388.44 |
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 $512.86 Median $691.83 Typical High $1,023.29 | Professional | None | $512.86 | $691.83 | $1,023.29 |
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 $218.78 Median $239.88 Typical High $257.04 | Professional | 52 · Reduced service | $218.78 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $95.50 Typical High $102.33 | Professional | 53 · Discontinued | $87.10 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $363.08 Typical High $389.05 | Professional | 54 · Surgery only | $323.59 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $72.44 Typical High $77.62 | Professional | 55 · Aftercare only | $64.57 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $47.86 Typical High $51.29 | Professional | 56 · Pre-op care only | $43.65 | $47.86 | $51.29 |
Where Missouri sits
The same service costs 3.9 times more in Alaska than in New York. 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· 31st of 51
$724
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.