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 $229.09 Median $4,897.79 Typical High $7,762.47 | Facility | None | $229.09 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $288.40 | Professional | None | $181.97 | $229.09 | $288.40 |
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 $125.89 Median $162.18 Typical High $281.84 | Professional | None | $125.89 | $162.18 | $281.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $79.43 Median $102.33 Typical High $177.83 | Professional | 62 · Two surgeons | $79.43 | $102.33 | $177.83 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $20.42 Median $26.30 Typical High $44.67 | Professional | 80 · Assistant surgeon | $20.42 | $26.30 | $44.67 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $17.78 Median $22.39 Typical High $38.90 | Professional | AS · PA/NP assist | $17.78 | $22.39 | $38.90 |
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 $194.98 Median $213.80 Typical High $446.68 | Professional | None | $194.98 | $213.80 | $446.68 |
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 $169.82 Median $275.42 Typical High $5,248.07 | Professional | None | $169.82 | $275.42 | $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 $218.78 Typical High $380.19 | Professional | None | $169.82 | $218.78 | $380.19 |
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 $134.90 Median $169.82 Typical High $173.78 | Professional | 54 · Surgery only | $134.90 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $33.88 Typical High $34.67 | Professional | 55 · Aftercare only | $27.54 | $33.88 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $22.91 Typical High $23.44 | Professional | 56 · Pre-op care only | $18.20 | $22.91 | $23.44 |
Where Missouri sits
The same service costs 10.5 times more in North Dakota 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· 41st of 51
$251
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.