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 $1,698.24 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $562.34 | Professional | None | $457.09 | $501.19 | $562.34 |
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 $501.19 Median $588.84 Typical High $831.76 | Professional | None | $501.19 | $588.84 | $831.76 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $93.33 Typical High $131.83 | Professional | 80 · Assistant surgeon | $79.43 | $93.33 | $131.83 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $81.28 Typical High $114.82 | Professional | AS · PA/NP assist | $69.18 | $81.28 | $114.82 |
BCBS Kansas City Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $691.83 | Professional | None | $446.68 | $489.78 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,951.21 Typical High $4,365.16 | Facility | None | $645.65 | $2,951.21 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $1,000.00 | Professional | None | $457.09 | $524.81 | $1,000.00 |
Medica Setting Facility Modifier None Typical Low $851.14 Median $4,073.80 Typical High $26,302.68 | Facility | None | $851.14 | $4,073.80 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $588.84 Median $4,786.30 Typical High $4,786.30 | Professional | None | $588.84 | $4,786.30 | $4,786.30 |
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 $467.74 Median $724.44 Typical High $1,202.26 | Professional | None | $467.74 | $724.44 | $1,202.26 |
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 $229.09 Median $245.47 Typical High $281.84 | Professional | 52 · Reduced service | $229.09 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $97.72 Typical High $112.20 | Professional | 53 · Discontinued | $91.20 | $97.72 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $363.08 Typical High $416.87 | Professional | 54 · Surgery only | $346.74 | $363.08 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $72.44 Typical High $83.18 | Professional | 55 · Aftercare only | $69.18 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $48.98 Typical High $56.23 | Professional | 56 · Pre-op care only | $45.71 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $338.84 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $323.59 | $338.84 | $389.05 |
Where Missouri sits
The same service costs 6.3 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· 27th of 51
$631
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.