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 $281.84 Median $4,897.79 Typical High $7,762.47 | Facility | None | $281.84 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $245.47 Typical High $281.84 | Professional | None | $229.09 | $245.47 | $281.84 |
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 $123.03 Median $147.91 Typical High $251.19 | Professional | None | $123.03 | $147.91 | $251.19 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $77.62 Median $93.33 Typical High $158.49 | Professional | 62 · Two surgeons | $77.62 | $93.33 | $158.49 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $19.50 Median $23.99 Typical High $40.74 | Professional | 80 · Assistant surgeon | $19.50 | $23.99 | $40.74 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $16.98 Median $20.89 Typical High $35.48 | Professional | AS · PA/NP assist | $16.98 | $20.89 | $35.48 |
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 $234.42 Median $245.47 Typical High $398.11 | Professional | None | $234.42 | $245.47 | $398.11 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,122.02 Typical High $7,943.28 | Facility | None | $54.95 | $1,122.02 | $7,943.28 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $371.54 Typical High $4,365.16 | Professional | None | $177.83 | $371.54 | $4,365.16 |
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 $165.96 Median $204.17 Typical High $338.84 | Professional | None | $165.96 | $204.17 | $338.84 |
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 $173.78 Median $181.97 Typical High $208.93 | Professional | 54 · Surgery only | $173.78 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $36.31 Typical High $41.69 | Professional | 55 · Aftercare only | $34.67 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $24.55 Typical High $28.18 | Professional | 56 · Pre-op care only | $22.91 | $24.55 | $28.18 |
Where Missouri sits
The same service costs 8.1 times more in New York than in Missouri. 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· 51st of 51
$224
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.