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 $436.52 Median $4,897.79 Typical High $7,762.47 | Facility | None | $436.52 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $380.19 Typical High $426.58 | Professional | None | $354.81 | $380.19 | $426.58 |
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 $389.05 Median $457.09 Typical High $691.83 | Professional | None | $389.05 | $457.09 | $691.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $245.47 Median $281.84 Typical High $436.52 | Professional | 62 · Two surgeons | $245.47 | $281.84 | $436.52 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $61.66 Median $72.44 Typical High $112.20 | Professional | 80 · Assistant surgeon | $61.66 | $72.44 | $112.20 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $54.95 Median $63.10 Typical High $97.72 | Professional | AS · PA/NP assist | $54.95 | $63.10 | $97.72 |
BCBS Kansas City Setting Professional Modifier None Typical Low $354.81 Median $389.05 Typical High $562.34 | Professional | None | $354.81 | $389.05 | $562.34 |
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 $363.08 Median $426.58 Typical High $776.25 | Professional | None | $363.08 | $426.58 | $776.25 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,071.52 Typical High $7,585.78 | Facility | None | $54.95 | $1,071.52 | $7,585.78 |
Medica Setting Professional Modifier None Typical Low $457.09 Median $2,754.23 Typical High $2,754.23 | Professional | None | $457.09 | $2,754.23 | $2,754.23 |
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 $363.08 Median $537.03 Typical High $912.01 | Professional | None | $363.08 | $537.03 | $912.01 |
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 $263.03 Median $281.84 Typical High $316.23 | Professional | 54 · Surgery only | $263.03 | $281.84 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $57.54 Typical High $64.57 | Professional | 55 · Aftercare only | $52.48 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $38.02 Typical High $42.66 | Professional | 56 · Pre-op care only | $35.48 | $38.02 | $42.66 |
Where Missouri sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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· 28th of 51
$490
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.