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 $2,511.89 Median $4,897.79 Typical High $7,762.47 | Facility | None | $2,511.89 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $3,630.78 Median $4,168.69 Typical High $4,466.84 | Professional | None | $3,630.78 | $4,168.69 | $4,466.84 |
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 $3,311.31 Median $3,890.45 Typical High $7,079.46 | Professional | None | $3,311.31 | $3,890.45 | $7,079.46 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $537.03 Median $616.60 Typical High $1,122.02 | Professional | 80 · Assistant surgeon | $537.03 | $616.60 | $1,122.02 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $467.74 Median $537.03 Typical High $1,000.00 | Professional | AS · PA/NP assist | $467.74 | $537.03 | $1,000.00 |
BCBS Kansas City Setting Professional Modifier None Typical Low $3,311.31 Median $3,548.13 Typical High $4,677.35 | Professional | None | $3,311.31 | $3,548.13 | $4,677.35 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,691.53 | Facility | None | $489.78 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $3,311.31 Median $4,570.88 Typical High $10,000.00 | Professional | None | $3,311.31 | $4,570.88 | $10,000.00 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,348.96 Typical High $10,964.78 | Facility | None | $54.95 | $1,348.96 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $4,677.35 Median $8,511.38 Typical High $24,547.09 | Professional | None | $4,677.35 | $8,511.38 | $24,547.09 |
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 $3,890.45 Median $6,025.60 Typical High $10,471.29 | Professional | None | $3,890.45 | $6,025.60 | $10,471.29 |
4 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 $1,819.70 Median $2,089.30 Typical High $2,238.72 | Professional | 52 · Reduced service | $1,819.70 | $2,089.30 | $2,238.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $724.44 Median $831.76 Typical High $891.25 | Professional | 53 · Discontinued | $724.44 | $831.76 | $891.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,691.53 Median $3,162.28 Typical High $3,311.31 | Professional | 54 · Surgery only | $2,691.53 | $3,162.28 | $3,311.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,511.89 Median $2,951.21 Typical High $3,090.30 | Professional | 78 · Unplanned return to OR | $2,511.89 | $2,951.21 | $3,090.30 |
Where Missouri sits
The same service costs 7.6 times more in Alaska than in Arkansas. 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· 32nd of 51
$4,074
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.