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 $1,659.59 Median $1,659.59 Typical High $6,025.60 | Professional | None | $1,659.59 | $1,659.59 | $6,025.60 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $831.76 Median $831.76 Typical High $3,019.95 | Professional | 52 · Reduced service | $831.76 | $831.76 | $3,019.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $1,230.27 | Professional | 53 · Discontinued | $331.13 | $331.13 | $1,230.27 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $4,570.88 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $4,570.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $912.01 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $912.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $602.56 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $602.56 |
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 $741.31 Median $977.24 Typical High $1,288.25 | Professional | None | $741.31 | $977.24 | $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 $338.84 Median $512.86 Typical High $602.56 | Professional | None | $338.84 | $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 $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,630.78 | $3,630.78 | $3,630.78 |
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 $117.49 Median $154.88 Typical High $204.17 | Professional | 80 · Assistant surgeon | $117.49 | $154.88 | $204.17 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $104.71 Median $134.90 Typical High $181.97 | Professional | AS · PA/NP assist | $104.71 | $134.90 | $181.97 |
Where Missouri sits
The same service costs 204.2 times more in Minnesota 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· 26th of 51
$1,660
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.