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 $1,698.24 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,584.89 Median $1,819.70 Typical High $2,398.83 | Professional | None | $1,584.89 | $1,819.70 | $2,398.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $3,467.37 Typical High $8,511.38 | Facility | None | $1,479.11 | $3,467.37 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $2,454.71 | Professional | None | $1,174.90 | $1,380.38 | $2,454.71 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $186.21 Median $218.78 Typical High $398.11 | Professional | 80 · Assistant surgeon | $186.21 | $218.78 | $398.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $162.18 Median $190.55 Typical High $346.74 | Professional | AS · PA/NP assist | $162.18 | $190.55 | $346.74 |
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 $1,412.54 Median $1,584.89 Typical High $4,365.16 | Professional | None | $1,412.54 | $1,584.89 | $4,365.16 |
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 $1,949.84 Median $3,388.44 Typical High $10,964.78 | Professional | None | $1,949.84 | $3,388.44 | $10,964.78 |
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 $1,548.82 Median $2,454.71 Typical High $4,073.80 | Professional | None | $1,548.82 | $2,454.71 | $4,073.80 |
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 $794.33 Median $912.01 Typical High $977.24 | Professional | 52 · Reduced service | $794.33 | $912.01 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $316.23 Median $363.08 Typical High $389.05 | Professional | 53 · Discontinued | $316.23 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,202.26 Median $1,380.38 Typical High $1,445.44 | Professional | 54 · Surgery only | $1,202.26 | $1,380.38 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $239.88 Median $275.42 Typical High $295.12 | Professional | 55 · Aftercare only | $239.88 | $275.42 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $158.49 Median $181.97 Typical High $194.98 | Professional | 56 · Pre-op care only | $158.49 | $181.97 | $194.98 |
Where Missouri sits
The same service costs 4.7 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· 28th of 51
$1,862
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.