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 $1,258.93 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,258.93 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,122.02 Typical High $1,318.26 | Professional | None | $1,096.48 | $1,122.02 | $1,318.26 |
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 $1,096.48 Median $1,258.93 Typical High $1,905.46 | Professional | None | $1,096.48 | $1,258.93 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $691.83 Median $794.33 Typical High $1,202.26 | Professional | 62 · Two surgeons | $691.83 | $794.33 | $1,202.26 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $173.78 Median $199.53 Typical High $302.00 | Professional | 80 · Assistant surgeon | $173.78 | $199.53 | $302.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $154.88 Median $173.78 Typical High $269.15 | Professional | AS · PA/NP assist | $154.88 | $173.78 | $269.15 |
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 $1,096.48 Median $1,148.15 Typical High $1,862.09 | Professional | None | $1,096.48 | $1,148.15 | $1,862.09 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,230.27 Typical High $9,772.37 | Facility | None | $54.95 | $1,230.27 | $9,772.37 |
Medica Setting Professional Modifier None Typical Low $1,258.93 Median $2,454.71 Typical High $8,511.38 | Professional | None | $1,258.93 | $2,454.71 | $8,511.38 |
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 $977.24 Median $1,621.81 Typical High $2,511.89 | Professional | None | $977.24 | $1,621.81 | $2,511.89 |
3 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 54 · Surgery only Typical Low $812.83 Median $831.76 Typical High $1,000.00 | Professional | 54 · Surgery only | $812.83 | $831.76 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $169.82 Typical High $199.53 | Professional | 55 · Aftercare only | $162.18 | $169.82 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $112.20 Typical High $131.83 | Professional | 56 · Pre-op care only | $109.65 | $112.20 | $131.83 |
Where Missouri sits
The same service costs 5.6 times more in Alaska than in New York. 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· 29th of 51
$1,380
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.