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 $549.54 Median $4,897.79 Typical High $7,762.47 | Facility | None | $549.54 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $524.81 | Professional | None | $426.58 | $478.63 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,479.11 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $1,023.29 | Professional | None | $512.86 | $616.60 | $1,023.29 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $323.59 Median $389.05 Typical High $645.65 | Professional | 62 · Two surgeons | $323.59 | $389.05 | $645.65 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $97.72 Typical High $162.18 | Professional | 80 · Assistant surgeon | $81.28 | $97.72 | $162.18 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $72.44 Median $85.11 Typical High $144.54 | Professional | AS · PA/NP assist | $72.44 | $85.11 | $144.54 |
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 $457.09 Median $478.63 Typical High $758.58 | Professional | None | $457.09 | $478.63 | $758.58 |
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 $588.84 Median $1,258.93 Typical High $16,595.87 | Professional | None | $588.84 | $1,258.93 | $16,595.87 |
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 $436.52 Median $741.31 Typical High $1,318.26 | Professional | None | $436.52 | $741.31 | $1,318.26 |
4 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 $323.59 Median $346.74 Typical High $389.05 | Professional | 54 · Surgery only | $323.59 | $346.74 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $69.18 Typical High $77.62 | Professional | 55 · Aftercare only | $64.57 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $45.71 Typical High $52.48 | Professional | 56 · Pre-op care only | $42.66 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $323.59 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $302.00 | $323.59 | $363.08 |
Where Missouri sits
The same service costs 11.7 times more in New York than in North Carolina. 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· 23rd of 51
$661
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.