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 $1,174.90 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,174.90 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,584.89 | Professional | None | $1,000.00 | $1,174.90 | $1,584.89 |
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 $912.01 Median $1,071.52 Typical High $1,995.26 | Professional | None | $912.01 | $1,071.52 | $1,995.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $173.78 Typical High $316.23 | Professional | 80 · Assistant surgeon | $144.54 | $173.78 | $316.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $125.89 Median $151.36 Typical High $275.42 | Professional | AS · PA/NP assist | $125.89 | $151.36 | $275.42 |
BCBS Kansas City Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $1,318.26 | Professional | None | $912.01 | $977.24 | $1,318.26 |
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 $912.01 Median $1,348.96 Typical High $2,818.38 | Professional | None | $912.01 | $1,348.96 | $2,818.38 |
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 $1,380.38 Median $2,398.83 Typical High $6,918.31 | Professional | None | $1,380.38 | $2,398.83 | $6,918.31 |
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 $1,096.48 Median $1,698.24 Typical High $2,951.21 | Professional | None | $1,096.48 | $1,698.24 | $2,951.21 |
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 $501.19 Median $588.84 Typical High $616.60 | Professional | 52 · Reduced service | $501.19 | $588.84 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $234.42 Typical High $251.19 | Professional | 53 · Discontinued | $199.53 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $870.96 Typical High $933.25 | Professional | 54 · Surgery only | $758.58 | $870.96 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $151.36 Median $173.78 Typical High $186.21 | Professional | 55 · Aftercare only | $151.36 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $117.49 Typical High $123.03 | Professional | 56 · Pre-op care only | $100.00 | $117.49 | $123.03 |
Where Missouri sits
The same service costs 3.7 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· 26th of 51
$1,413
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.