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 $2,089.30 Median $5,623.41 Typical High $8,709.64 | Facility | None | $2,089.30 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $1,000.00 Typical High $1,096.48 | Professional | None | $912.01 | $1,000.00 | $1,096.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $8,709.64 | Facility | None | $1,318.26 | $3,467.37 | $8,709.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,584.89 | Professional | None | $912.01 | $1,071.52 | $1,584.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $169.82 Typical High $245.47 | Professional | 80 · Assistant surgeon | $144.54 | $169.82 | $245.47 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $147.91 Typical High $213.80 | Professional | AS · PA/NP assist | $128.82 | $147.91 | $213.80 |
BCBS Kansas City Setting Professional Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,479.11 | Professional | None | $954.99 | $1,071.52 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $3,630.78 Typical High $4,365.16 | Facility | None | $912.01 | $3,630.78 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,819.70 | Professional | None | $891.25 | $1,023.29 | $1,819.70 |
Medica Setting Facility Modifier None Typical Low $1,122.02 Median $2,884.03 Typical High $16,595.87 | Facility | None | $1,122.02 | $2,884.03 | $16,595.87 |
Medica Setting Professional Modifier None Typical Low $1,174.90 Median $7,413.10 Typical High $7,413.10 | Professional | None | $1,174.90 | $7,413.10 | $7,413.10 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,981.07 | $8,709.64 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,318.26 Typical High $2,344.23 | Professional | None | $912.01 | $1,318.26 | $2,344.23 |
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 $457.09 Median $467.74 Typical High $549.54 | Professional | 52 · Reduced service | $457.09 | $467.74 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $190.55 Typical High $218.78 | Professional | 53 · Discontinued | $181.97 | $190.55 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $707.95 Typical High $831.76 | Professional | 54 · Surgery only | $676.08 | $707.95 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $141.25 Typical High $165.96 | Professional | 55 · Aftercare only | $134.90 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $95.50 Typical High $109.65 | Professional | 56 · Pre-op care only | $91.20 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $660.69 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $630.96 | $660.69 | $776.25 |
Where Missouri sits
The same service costs 5.8 times more in Alaska than in Texas. 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· 30th of 51
$1,148
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.