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 $2,454.71 Median $5,623.41 Typical High $13,803.84 | Facility | None | $2,454.71 | $5,623.41 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $2,089.30 | Professional | None | $707.95 | $870.96 | $2,089.30 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $10,964.78 | Facility | None | $1,412.54 | $3,801.89 | $10,964.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $912.01 Median $1,230.27 Typical High $1,698.24 | Professional | None | $912.01 | $1,230.27 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $144.54 Median $194.98 Typical High $269.15 | Professional | 80 · Assistant surgeon | $144.54 | $194.98 | $269.15 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $128.82 Median $169.82 Typical High $234.42 | Professional | AS · PA/NP assist | $128.82 | $169.82 | $234.42 |
BCBS Kansas City Setting Professional Modifier None Typical Low $812.83 Median $912.01 Typical High $1,258.93 | Professional | None | $812.83 | $912.01 | $1,258.93 |
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 $870.96 Median $1,047.13 Typical High $2,089.30 | Professional | None | $870.96 | $1,047.13 | $2,089.30 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,230.27 Typical High $7,585.78 | Facility | None | $54.95 | $1,230.27 | $7,585.78 |
Medica Setting Professional Modifier None Typical Low $977.24 Median $2,344.23 Typical High $6,760.83 | Professional | None | $977.24 | $2,344.23 | $6,760.83 |
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 $954.99 Median $1,288.25 Typical High $2,398.83 | Professional | None | $954.99 | $1,288.25 | $2,398.83 |
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 $354.81 Median $436.52 Typical High $446.68 | Professional | 52 · Reduced service | $354.81 | $436.52 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $173.78 Typical High $181.97 | Professional | 53 · Discontinued | $141.25 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $660.69 Typical High $676.08 | Professional | 54 · Surgery only | $524.81 | $660.69 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $131.83 Typical High $134.90 | Professional | 55 · Aftercare only | $104.71 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $87.10 Typical High $91.20 | Professional | 56 · Pre-op care only | $70.79 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $616.60 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $489.78 | $616.60 | $630.96 |
Where Missouri sits
The same service costs 6.3 times more in Alaska 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· 24th of 51
$1,230
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.