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 $1,995.26 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,995.26 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $3,467.37 | Professional | None | $1,995.26 | $1,995.26 | $3,467.37 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,000.00 Median $1,000.00 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $691.83 | Professional | 53 · Discontinued | $398.11 | $398.11 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,479.11 Typical High $2,570.40 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $2,570.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $524.81 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $346.74 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $346.74 |
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 $602.56 Median $758.58 Typical High $1,288.25 | Professional | None | $602.56 | $758.58 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,691.53 | Facility | None | $489.78 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $512.86 Typical High $602.56 | Professional | None | $302.00 | $512.86 | $602.56 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,230.27 Typical High $7,943.28 | Facility | None | $54.95 | $1,230.27 | $7,943.28 |
Medica Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Professional | None | $4,677.35 | $4,677.35 | $4,677.35 |
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 |
2 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 |
|---|---|---|---|---|---|
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $95.50 Median $123.03 Typical High $204.17 | Professional | 80 · Assistant surgeon | $95.50 | $123.03 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $83.18 Median $107.15 Typical High $181.97 | Professional | AS · PA/NP assist | $83.18 | $107.15 | $181.97 |
Where Missouri sits
The same service costs 117.5 times more in Nebraska than in Hawaii. 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· 15th of 51
$1,995
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.