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 $251.19 Median $4,897.79 Typical High $7,762.47 | Facility | None | $251.19 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $524.81 | Professional | None | $204.17 | $257.04 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $199.53 Typical High $602.56 | Professional | None | $134.90 | $199.53 | $602.56 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $85.11 Median $125.89 Typical High $380.19 | Professional | 62 · Two surgeons | $85.11 | $125.89 | $380.19 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $21.38 Median $34.67 Typical High $95.50 | Professional | 80 · Assistant surgeon | $21.38 | $34.67 | $95.50 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $18.62 Median $30.20 Typical High $83.18 | Professional | AS · PA/NP assist | $18.62 | $30.20 | $83.18 |
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 $218.78 Median $234.42 Typical High $501.19 | Professional | None | $218.78 | $234.42 | $501.19 |
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 $181.97 Median $281.84 Typical High $5,248.07 | Professional | None | $181.97 | $281.84 | $5,248.07 |
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 $169.82 Median $239.88 Typical High $389.05 | Professional | None | $169.82 | $239.88 | $389.05 |
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 $151.36 Median $190.55 Typical High $194.98 | Professional | 54 · Surgery only | $151.36 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $38.02 Typical High $38.90 | Professional | 55 · Aftercare only | $30.20 | $38.02 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $25.12 Typical High $25.70 | Professional | 56 · Pre-op care only | $20.42 | $25.12 | $25.70 |
Where Missouri sits
The same service costs 8.5 times more in New York than in Kentucky. 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· 39th of 51
$282
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.