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 $891.25 Median $4,897.79 Typical High $7,762.47 | Facility | None | $891.25 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,202.26 | Professional | None | $758.58 | $891.25 | $1,202.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,479.11 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $676.08 Median $812.83 Typical High $1,513.56 | Professional | None | $676.08 | $812.83 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $131.83 Typical High $239.88 | Professional | 80 · Assistant surgeon | $109.65 | $131.83 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $114.82 Typical High $208.93 | Professional | AS · PA/NP assist | $95.50 | $114.82 | $208.93 |
BCBS Kansas City Setting Professional Modifier None Typical Low $691.83 Median $741.31 Typical High $1,000.00 | Professional | None | $691.83 | $741.31 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,137.96 Typical High $2,691.53 | Facility | None | $575.44 | $2,137.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $1,023.29 Typical High $2,137.96 | Professional | None | $691.83 | $1,023.29 | $2,137.96 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,230.27 Typical High $10,964.78 | Facility | None | $54.95 | $1,230.27 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $1,023.29 Median $1,819.70 Typical High $5,248.07 | Professional | None | $1,023.29 | $1,819.70 | $5,248.07 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,290.87 Typical High $10,964.78 | Facility | None | $467.74 | $2,290.87 | $10,964.78 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,288.25 Typical High $2,187.76 | Professional | None | $831.76 | $1,288.25 | $2,187.76 |
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 $380.19 Median $446.68 Typical High $467.74 | Professional | 52 · Reduced service | $380.19 | $446.68 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $177.83 Typical High $186.21 | Professional | 53 · Discontinued | $151.36 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $660.69 Typical High $707.95 | Professional | 54 · Surgery only | $575.44 | $660.69 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $131.83 Typical High $141.25 | Professional | 55 · Aftercare only | $114.82 | $131.83 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $89.13 Typical High $93.33 | Professional | 56 · Pre-op care only | $75.86 | $89.13 | $93.33 |
Where Missouri sits
The same service costs 3.8 times more in Wisconsin 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· 20th of 51
$1,122
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.