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 $1,258.93 Median $4,677.35 Typical High $7,762.47 | Facility | None | $1,258.93 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $512.86 | Professional | None | $257.04 | $316.23 | $512.86 |
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 $309.03 Median $407.38 Typical High $616.60 | Professional | None | $309.03 | $407.38 | $616.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $48.98 Median $64.57 Typical High $97.72 | Professional | 80 · Assistant surgeon | $48.98 | $64.57 | $97.72 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $42.66 Median $56.23 Typical High $85.11 | Professional | AS · PA/NP assist | $42.66 | $56.23 | $85.11 |
BCBS Kansas City Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $467.74 | Professional | None | $302.00 | $331.13 | $467.74 |
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 $316.23 Median $371.54 Typical High $758.58 | Professional | None | $316.23 | $371.54 | $758.58 |
Medica Setting Facility Modifier None Typical Low $645.65 Median $2,754.23 Typical High $26,302.68 | Facility | None | $645.65 | $2,754.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $812.83 Typical High $2,511.89 | Professional | None | $331.13 | $812.83 | $2,511.89 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $870.96 | Professional | None | $316.23 | $446.68 | $870.96 |
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 $128.82 Median $158.49 Typical High $165.96 | Professional | 52 · Reduced service | $128.82 | $158.49 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $64.57 Typical High $66.07 | Professional | 53 · Discontinued | $51.29 | $64.57 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $239.88 Typical High $245.47 | Professional | 54 · Surgery only | $194.98 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $47.86 Typical High $48.98 | Professional | 55 · Aftercare only | $38.90 | $47.86 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $31.62 Typical High $33.11 | Professional | 56 · Pre-op care only | $25.70 | $31.62 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $223.87 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $181.97 | $223.87 | $229.09 |
Where Missouri sits
The same service costs 11.2 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· 30th of 51
$468
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.