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 $489.78 Median $4,897.79 Typical High $7,762.47 | Facility | None | $489.78 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $489.78 Typical High $2,511.89 | Professional | None | $416.87 | $489.78 | $2,511.89 |
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 $257.04 Median $346.74 Typical High $602.56 | Professional | None | $257.04 | $346.74 | $602.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $162.18 Median $213.80 Typical High $380.19 | Professional | 62 · Two surgeons | $162.18 | $213.80 | $380.19 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $40.74 Median $54.95 Typical High $97.72 | Professional | 80 · Assistant surgeon | $40.74 | $54.95 | $97.72 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $36.31 Median $48.98 Typical High $85.11 | Professional | AS · PA/NP assist | $36.31 | $48.98 | $85.11 |
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 $398.11 Median $416.87 Typical High $1,230.27 | Professional | None | $398.11 | $416.87 | $1,230.27 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,174.90 Typical High $7,943.28 | Facility | None | $54.95 | $1,174.90 | $7,943.28 |
Medica Setting Professional Modifier None Typical Low $398.11 Median $660.69 Typical High $7,244.36 | Professional | None | $398.11 | $660.69 | $7,244.36 |
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 $398.11 Median $512.86 Typical High $912.01 | Professional | None | $398.11 | $512.86 | $912.01 |
3 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 54 · Surgery only Typical Low $316.23 Median $363.08 Typical High $389.05 | Professional | 54 · Surgery only | $316.23 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $72.44 Typical High $77.62 | Professional | 55 · Aftercare only | $63.10 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $48.98 Typical High $51.29 | Professional | 56 · Pre-op care only | $41.69 | $48.98 | $51.29 |
Where Missouri sits
The same service costs 7.1 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· 40th of 51
$575
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.