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 $2,511.89 Median $4,897.79 Typical High $7,762.47 | Facility | None | $2,511.89 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $7,585.78 | Professional | None | $3,162.28 | $3,162.28 | $7,585.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1,584.89 Median $1,584.89 Typical High $3,801.89 | Professional | 52 · Reduced service | $1,584.89 | $1,584.89 | $3,801.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $630.96 Typical High $1,513.56 | Professional | 53 · Discontinued | $630.96 | $630.96 | $1,513.56 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $2,344.23 Typical High $5,623.41 | Professional | 54 · Surgery only | $2,344.23 | $2,344.23 | $5,623.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $467.74 Typical High $1,122.02 | Professional | 55 · Aftercare only | $467.74 | $467.74 | $1,122.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $316.23 Typical High $758.58 | Professional | 56 · Pre-op care only | $316.23 | $316.23 | $758.58 |
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 $870.96 Median $2,137.96 Typical High $2,691.53 | Professional | None | $870.96 | $2,137.96 | $2,691.53 |
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 $42,657.95 Median $42,657.95 Typical High $42,657.95 | Professional | None | $42,657.95 | $42,657.95 | $42,657.95 |
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 $138.04 Median $331.13 Typical High $436.52 | Professional | 80 · Assistant surgeon | $138.04 | $331.13 | $436.52 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $288.40 Typical High $380.19 | Professional | AS · PA/NP assist | $120.23 | $288.40 | $380.19 |
Where Missouri sits
The same service costs 257.0 times more in Wisconsin 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· 22nd of 51
$3,162
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.