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 $275.42 Median $4,897.79 Typical High $7,762.47 | Facility | None | $275.42 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $239.88 Typical High $269.15 | Professional | None | $223.87 | $239.88 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $10,471.29 | Facility | None | $1,412.54 | $3,801.89 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $407.38 | Professional | None | $245.47 | $302.00 | $407.38 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $154.88 Median $190.55 Typical High $257.04 | Professional | 62 · Two surgeons | $154.88 | $190.55 | $257.04 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $39.81 Median $47.86 Typical High $66.07 | Professional | 80 · Assistant surgeon | $39.81 | $47.86 | $66.07 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $34.67 Median $42.66 Typical High $57.54 | Professional | AS · PA/NP assist | $34.67 | $42.66 | $57.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $223.87 Median $245.47 Typical High $346.74 | Professional | None | $223.87 | $245.47 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,137.96 Typical High $2,691.53 | Facility | None | $588.84 | $2,137.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $489.78 | Professional | None | $229.09 | $269.15 | $489.78 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,071.52 Typical High $6,918.31 | Facility | None | $54.95 | $1,071.52 | $6,918.31 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $4,365.16 Typical High $4,365.16 | Professional | None | $288.40 | $4,365.16 | $4,365.16 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,290.87 Typical High $10,964.78 | Facility | None | $467.74 | $2,290.87 | $10,964.78 |
United Setting Professional Modifier None Typical Low $229.09 Median $338.84 Typical High $588.84 | Professional | None | $229.09 | $338.84 | $588.84 |
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 $112.20 Median $120.23 Typical High $134.90 | Professional | 52 · Reduced service | $112.20 | $120.23 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $47.86 Typical High $53.70 | Professional | 53 · Discontinued | $44.67 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $177.83 Typical High $204.17 | Professional | 54 · Surgery only | $165.96 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $35.48 Typical High $40.74 | Professional | 55 · Aftercare only | $33.11 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $23.99 Typical High $26.92 | Professional | 56 · Pre-op care only | $22.39 | $23.99 | $26.92 |
Where Missouri sits
The same service costs 5.0 times more in Alaska than in Utah. 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· 24th of 51
$331
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.