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 $1,148.15 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,148.15 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $114.82 Typical High $2,570.40 | Professional | None | $109.65 | $114.82 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,819.70 Typical High $3,981.07 | Facility | None | $724.44 | $1,819.70 | $3,981.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $208.93 | Professional | None | $102.33 | $120.23 | $208.93 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $16.22 Median $19.05 Typical High $33.11 | Professional | 80 · Assistant surgeon | $16.22 | $19.05 | $33.11 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $14.13 Median $16.60 Typical High $29.51 | Professional | AS · PA/NP assist | $14.13 | $16.60 | $29.51 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,380.38 Typical High $5,011.87 | Facility | None | $54.95 | $1,380.38 | $5,011.87 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $162.18 Typical High $288.40 | Professional | None | $100.00 | $162.18 | $288.40 |
United Setting Facility Modifier None Typical Low $1,202.26 Median $2,454.71 Typical High $4,897.79 | Facility | None | $1,202.26 | $2,454.71 | $4,897.79 |
United Setting Professional Modifier None Typical Low $107.15 Median $190.55 Typical High $288.40 | Professional | None | $107.15 | $190.55 | $288.40 |
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 $54.95 Median $54.95 Typical High $61.66 | Professional | 52 · Reduced service | $54.95 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $21.88 Typical High $25.12 | Professional | 53 · Discontinued | $21.88 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $83.18 Typical High $93.33 | Professional | 54 · Surgery only | $81.28 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.60 Typical High $18.62 | Professional | 55 · Aftercare only | $16.22 | $16.60 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $10.96 Typical High $12.30 | Professional | 56 · Pre-op care only | $10.96 | $10.96 | $12.30 |
Where Missouri sits
The same service costs 37.2 times more in Oklahoma 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· 35th of 51
$178
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.