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 $912.01 Median $4,897.79 Typical High $7,762.47 | Facility | None | $912.01 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $891.25 Typical High $1,230.27 | Professional | None | $776.25 | $891.25 | $1,230.27 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,762.47 | Facility | None | $1,318.26 | $3,467.37 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $1,412.54 | Professional | None | $562.34 | $724.44 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $89.13 Median $114.82 Typical High $229.09 | Professional | 80 · Assistant surgeon | $89.13 | $114.82 | $229.09 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $79.43 Median $100.00 Typical High $199.53 | Professional | AS · PA/NP assist | $79.43 | $100.00 | $199.53 |
BCBS Kansas City Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $1,096.48 | Professional | None | $724.44 | $812.83 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,089.30 Typical High $2,691.53 | Facility | None | $707.95 | $2,089.30 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $776.25 Typical High $1,698.24 | Professional | None | $691.83 | $776.25 | $1,698.24 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,187.76 Typical High $9,332.54 | Facility | None | $54.95 | $2,187.76 | $9,332.54 |
Medica Setting Professional Modifier None Typical Low $758.58 Median $1,905.46 Typical High $5,248.07 | Professional | None | $758.58 | $1,905.46 | $5,248.07 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,467.37 | $6,918.31 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,230.27 Typical High $2,238.72 | Professional | None | $724.44 | $1,230.27 | $2,238.72 |
6 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 $389.05 Median $446.68 Typical High $478.63 | Professional | 52 · Reduced service | $389.05 | $446.68 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $177.83 Typical High $194.98 | Professional | 53 · Discontinued | $154.88 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $676.08 Typical High $724.44 | Professional | 54 · Surgery only | $575.44 | $676.08 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $134.90 Typical High $144.54 | Professional | 55 · Aftercare only | $114.82 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $89.13 Typical High $97.72 | Professional | 56 · Pre-op care only | $77.62 | $89.13 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $630.96 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $537.03 | $630.96 | $676.08 |
Where Missouri sits
The same service costs 6.8 times more in Oklahoma 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· 29th of 51
$1,096
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.