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 $933.25 Median $5,623.41 Typical High $10,715.19 | Facility | None | $933.25 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $977.24 | Professional | None | $616.60 | $794.33 | $977.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $1,288.25 | Professional | None | $691.83 | $812.83 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $109.65 Median $128.82 Typical High $199.53 | Professional | 80 · Assistant surgeon | $109.65 | $128.82 | $199.53 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $95.50 Median $112.20 Typical High $177.83 | Professional | AS · PA/NP assist | $95.50 | $112.20 | $177.83 |
BCBS Kansas City Setting Professional Modifier None Typical Low $616.60 Median $851.14 Typical High $1,202.26 | Professional | None | $616.60 | $851.14 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $3,311.31 Typical High $4,365.16 | Facility | None | $758.58 | $3,311.31 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,380.38 | Professional | None | $660.69 | $851.14 | $1,380.38 |
Medica Setting Facility Modifier None Typical Low $954.99 Median $2,754.23 Typical High $26,302.68 | Facility | None | $954.99 | $2,754.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $1,096.48 Median $5,011.87 Typical High $6,456.54 | Professional | None | $1,096.48 | $5,011.87 | $6,456.54 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,047.13 Typical High $1,621.81 | Professional | None | $691.83 | $1,047.13 | $1,621.81 |
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 $309.03 Median $398.11 Typical High $467.74 | Professional | 52 · Reduced service | $309.03 | $398.11 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $158.49 Typical High $186.21 | Professional | 53 · Discontinued | $125.89 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $602.56 Typical High $691.83 | Professional | 54 · Surgery only | $467.74 | $602.56 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $120.23 Typical High $138.04 | Professional | 55 · Aftercare only | $93.33 | $120.23 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $79.43 Typical High $93.33 | Professional | 56 · Pre-op care only | $61.66 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $562.34 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $436.52 | $562.34 | $645.65 |
Where Missouri sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 32nd of 51
$912
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.