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 $501.19 Median $4,897.79 Typical High $7,762.47 | Facility | None | $501.19 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $501.19 Typical High $691.83 | Professional | None | $436.52 | $501.19 | $691.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $758.58 | Professional | None | $363.08 | $416.87 | $758.58 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $58.88 Median $67.61 Typical High $120.23 | Professional | 80 · Assistant surgeon | $58.88 | $67.61 | $120.23 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $51.29 Median $58.88 Typical High $107.15 | Professional | AS · PA/NP assist | $51.29 | $58.88 | $107.15 |
BCBS Kansas City Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $575.44 | Professional | None | $398.11 | $426.58 | $575.44 |
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 $549.54 Typical High $1,202.26 | Professional | None | $398.11 | $549.54 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,174.90 Typical High $7,585.78 | Facility | None | $54.95 | $1,174.90 | $7,585.78 |
Medica Setting Professional Modifier None Typical Low $588.84 Median $1,023.29 Typical High $2,951.21 | Professional | None | $588.84 | $1,023.29 | $2,951.21 |
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 $467.74 Median $741.31 Typical High $1,258.93 | Professional | None | $467.74 | $741.31 | $1,258.93 |
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 $218.78 Median $251.19 Typical High $269.15 | Professional | 52 · Reduced service | $218.78 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $100.00 Typical High $107.15 | Professional | 53 · Discontinued | $87.10 | $100.00 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $380.19 Typical High $407.38 | Professional | 54 · Surgery only | $331.13 | $380.19 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $75.86 Typical High $81.28 | Professional | 55 · Aftercare only | $66.07 | $75.86 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $50.12 Typical High $53.70 | Professional | 56 · Pre-op care only | $43.65 | $50.12 | $53.70 |
Where Missouri sits
The same service costs 4.1 times more in Wisconsin than in Kentucky. 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· 39th of 51
$550
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.