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 $1,412.54 Median $5,495.41 Typical High $8,511.38 | Facility | None | $1,412.54 | $5,495.41 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $309.03 Typical High $1,148.15 | Professional | None | $239.88 | $309.03 | $1,148.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,890.45 Typical High $7,079.46 | Facility | None | $1,412.54 | $3,890.45 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $537.03 Typical High $724.44 | Professional | None | $346.74 | $537.03 | $724.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $218.78 Median $338.84 Typical High $457.09 | Professional | 62 · Two surgeons | $218.78 | $338.84 | $457.09 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $56.23 Median $87.10 Typical High $114.82 | Professional | 80 · Assistant surgeon | $56.23 | $87.10 | $114.82 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $48.98 Median $75.86 Typical High $102.33 | Professional | AS · PA/NP assist | $48.98 | $75.86 | $102.33 |
BCBS Kansas City Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $457.09 | Professional | None | $281.84 | $309.03 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $2,691.53 Typical High $7,762.47 | Facility | None | $741.31 | $2,691.53 | $7,762.47 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $389.05 Typical High $776.25 | Professional | None | $295.12 | $389.05 | $776.25 |
Medica Setting Facility Modifier None Typical Low $707.95 Median $3,801.89 Typical High $26,302.68 | Facility | None | $707.95 | $3,801.89 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $354.81 Median $812.83 Typical High $4,786.30 | Professional | None | $354.81 | $812.83 | $4,786.30 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,548.13 Typical High $7,413.10 | Facility | None | $1,000.00 | $3,548.13 | $7,413.10 |
United Setting Professional Modifier None Typical Low $331.13 Median $467.74 Typical High $812.83 | Professional | None | $331.13 | $467.74 | $812.83 |
5 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 $120.23 Median $147.91 Typical High $154.88 | Professional | 52 · Reduced service | $120.23 | $147.91 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $58.88 Typical High $61.66 | Professional | 53 · Discontinued | $47.86 | $58.88 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $223.87 Typical High $229.09 | Professional | 54 · Surgery only | $177.83 | $223.87 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $44.67 Typical High $45.71 | Professional | 55 · Aftercare only | $35.48 | $44.67 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $29.51 Typical High $30.90 | Professional | 56 · Pre-op care only | $23.99 | $29.51 | $30.90 |
Where Missouri sits
The same service costs 10.0 times more in Oklahoma than in New York. 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· 14th of 51
$646
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.