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 $1,698.24 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $1,698.24 | Professional | None | $758.58 | $870.96 | $1,698.24 |
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 $831.76 Median $1,202.26 Typical High $1,548.82 | Professional | None | $831.76 | $1,202.26 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $131.83 Median $190.55 Typical High $257.04 | Professional | 80 · Assistant surgeon | $131.83 | $190.55 | $257.04 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $114.82 Median $165.96 Typical High $223.87 | Professional | AS · PA/NP assist | $114.82 | $165.96 | $223.87 |
BCBS Kansas City Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $1,047.13 | Professional | None | $691.83 | $758.58 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,137.96 Typical High $2,691.53 | Facility | None | $645.65 | $2,137.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $1,698.24 | Professional | None | $741.31 | $851.14 | $1,698.24 |
Medica Setting Facility Modifier None Typical Low $1,071.52 Median $4,073.80 Typical High $26,302.68 | Facility | None | $1,071.52 | $4,073.80 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $1,949.84 Typical High $5,623.41 | Professional | None | $851.14 | $1,949.84 | $5,623.41 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,981.07 | $8,709.64 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,071.52 Typical High $2,089.30 | Professional | None | $776.25 | $1,071.52 | $2,089.30 |
6 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 52 · Reduced service Typical Low $380.19 Median $426.58 Typical High $467.74 | Professional | 52 · Reduced service | $380.19 | $426.58 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $169.82 Typical High $186.21 | Professional | 53 · Discontinued | $151.36 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $645.65 Typical High $707.95 | Professional | 54 · Surgery only | $562.34 | $645.65 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $128.82 Typical High $141.25 | Professional | 55 · Aftercare only | $114.82 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $85.11 Typical High $93.33 | Professional | 56 · Pre-op care only | $75.86 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $602.56 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $524.81 | $602.56 | $660.69 |
Where Missouri sits
The same service costs 7.9 times more in Oklahoma than in Utah. 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· 22nd of 51
$1,202
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.