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 $338.84 Median $4,897.79 Typical High $7,762.47 | Facility | None | $338.84 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $338.84 Typical High $446.68 | Professional | None | $295.12 | $338.84 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $3,467.37 Typical High $7,762.47 | Facility | None | $1,479.11 | $3,467.37 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $602.56 | Professional | None | $302.00 | $426.58 | $602.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $190.55 Median $269.15 Typical High $380.19 | Professional | 62 · Two surgeons | $190.55 | $269.15 | $380.19 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $48.98 Median $69.18 Typical High $95.50 | Professional | 80 · Assistant surgeon | $48.98 | $69.18 | $95.50 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $42.66 Median $60.26 Typical High $85.11 | Professional | AS · PA/NP assist | $42.66 | $60.26 | $85.11 |
BCBS Kansas City Setting Professional Modifier None Typical Low $263.03 Median $288.40 Typical High $380.19 | Professional | None | $263.03 | $288.40 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,137.96 Typical High $2,691.53 | Facility | None | $588.84 | $2,137.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $812.83 | Professional | None | $269.15 | $389.05 | $812.83 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,071.52 Typical High $6,918.31 | Facility | None | $54.95 | $1,071.52 | $6,918.31 |
Medica Setting Professional Modifier None Typical Low $398.11 Median $741.31 Typical High $14,791.08 | Professional | None | $398.11 | $741.31 | $14,791.08 |
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 $316.23 Median $501.19 Typical High $851.14 | Professional | None | $316.23 | $501.19 | $851.14 |
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 $147.91 Median $169.82 Typical High $181.97 | Professional | 52 · Reduced service | $147.91 | $169.82 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $67.61 Typical High $72.44 | Professional | 53 · Discontinued | $58.88 | $67.61 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $257.04 Typical High $275.42 | Professional | 54 · Surgery only | $218.78 | $257.04 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $51.29 Typical High $54.95 | Professional | 55 · Aftercare only | $44.67 | $51.29 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $33.88 Typical High $36.31 | Professional | 56 · Pre-op care only | $29.51 | $33.88 | $36.31 |
Where Missouri sits
The same service costs 3.9 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· 13th of 51
$562
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.