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 $1,548.82 Median $3,981.07 Typical High $7,762.47 | Facility | None | $1,548.82 | $3,981.07 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $676.08 | Professional | None | $257.04 | $331.13 | $676.08 |
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 $338.84 Median $436.52 Typical High $616.60 | Professional | None | $338.84 | $436.52 | $616.60 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $53.70 Median $70.79 Typical High $100.00 | Professional | 80 · Assistant surgeon | $53.70 | $70.79 | $100.00 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $46.77 Median $61.66 Typical High $87.10 | Professional | AS · PA/NP assist | $46.77 | $61.66 | $87.10 |
BCBS Kansas City Setting Professional Modifier None Typical Low $302.00 Median $338.84 Typical High $467.74 | Professional | None | $302.00 | $338.84 | $467.74 |
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 $323.59 Median $436.52 Typical High $758.58 | Professional | None | $323.59 | $436.52 | $758.58 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $933.25 Typical High $3,090.30 | Facility | None | $54.95 | $933.25 | $3,090.30 |
Medica Setting Professional Modifier None Typical Low $354.81 Median $851.14 Typical High $2,818.38 | Professional | None | $354.81 | $851.14 | $2,818.38 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,235.94 | Facility | None | $562.34 | $1,513.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $870.96 | Professional | None | $346.74 | $467.74 | $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 $162.18 Typical High $165.96 | Professional | 52 · Reduced service | $128.82 | $162.18 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $64.57 Typical High $66.07 | Professional | 53 · Discontinued | $52.48 | $64.57 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $239.88 Typical High $251.19 | Professional | 54 · Surgery only | $194.98 | $239.88 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $47.86 Typical High $50.12 | Professional | 55 · Aftercare only | $38.90 | $47.86 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $32.36 Typical High $33.11 | Professional | 56 · Pre-op care only | $25.70 | $32.36 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $223.87 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $181.97 | $223.87 | $234.42 |
Where Missouri sits
The same service costs 5.8 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· 25th of 51
$490
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.