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 $2,344.23 Median $4,897.79 Typical High $7,762.47 | Facility | None | $2,344.23 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,691.53 Typical High $2,754.23 | Professional | None | $2,344.23 | $2,691.53 | $2,754.23 |
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 $2,818.38 Median $3,311.31 Typical High $5,888.44 | Professional | None | $2,818.38 | $3,311.31 | $5,888.44 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $446.68 Median $524.81 Typical High $954.99 | Professional | 80 · Assistant surgeon | $446.68 | $524.81 | $954.99 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $389.05 Median $457.09 Typical High $831.76 | Professional | AS · PA/NP assist | $389.05 | $457.09 | $831.76 |
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 $2,238.72 Median $2,290.87 Typical High $7,244.36 | Professional | None | $2,238.72 | $2,290.87 | $7,244.36 |
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 $2,398.83 Median $3,981.07 Typical High $17,378.01 | Professional | None | $2,398.83 | $3,981.07 | $17,378.01 |
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 $2,089.30 Median $2,818.38 Typical High $9,120.11 | Professional | None | $2,089.30 | $2,818.38 | $9,120.11 |
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 $1,174.90 Median $1,348.96 Typical High $1,348.96 | Professional | 52 · Reduced service | $1,174.90 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $537.03 Typical High $549.54 | Professional | 53 · Discontinued | $467.74 | $537.03 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,995.26 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,737.80 | $1,995.26 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $398.11 Typical High $407.38 | Professional | 55 · Aftercare only | $346.74 | $398.11 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $269.15 Typical High $269.15 | Professional | 56 · Pre-op care only | $234.42 | $269.15 | $269.15 |
Where Missouri sits
The same service costs 5.6 times more in Alaska than in South Carolina. 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· 22nd of 51
$3,236
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.