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 $2,511.89 Median $6,606.93 Typical High $13,489.63 | Facility | None | $2,511.89 | $6,606.93 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $794.33 Typical High $3,890.45 | Professional | None | $630.96 | $794.33 | $3,890.45 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $4,677.35 Typical High $13,182.57 | Facility | None | $1,380.38 | $4,677.35 | $13,182.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,513.56 | Professional | None | $758.58 | $891.25 | $1,513.56 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $123.03 Median $144.54 Typical High $239.88 | Professional | 80 · Assistant surgeon | $123.03 | $144.54 | $239.88 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $107.15 Median $125.89 Typical High $208.93 | Professional | AS · PA/NP assist | $107.15 | $125.89 | $208.93 |
BCBS Kansas City Setting Professional Modifier None Typical Low $724.44 Median $812.83 Typical High $1,122.02 | Professional | None | $724.44 | $812.83 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $5,623.41 Typical High $12,022.64 | Facility | None | $851.14 | $5,623.41 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,862.09 | Professional | None | $776.25 | $1,000.00 | $1,862.09 |
Medica Setting Facility Modifier None Typical Low $1,023.29 Median $5,495.41 Typical High $27,542.29 | Facility | None | $1,023.29 | $5,495.41 | $27,542.29 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $1,348.96 Typical High $6,025.60 | Professional | None | $851.14 | $1,348.96 | $6,025.60 |
United Setting Facility Modifier None Typical Low $1,023.29 Median $5,011.87 Typical High $13,489.63 | Facility | None | $1,023.29 | $5,011.87 | $13,489.63 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,148.15 Typical High $2,137.96 | Professional | None | $831.76 | $1,148.15 | $2,137.96 |
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 $316.23 Median $389.05 Typical High $398.11 | Professional | 52 · Reduced service | $316.23 | $389.05 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $154.88 Typical High $158.49 | Professional | 53 · Discontinued | $125.89 | $154.88 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $588.84 Typical High $602.56 | Professional | 54 · Surgery only | $467.74 | $588.84 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $117.49 Typical High $120.23 | Professional | 55 · Aftercare only | $93.33 | $117.49 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $77.62 Typical High $79.43 | Professional | 56 · Pre-op care only | $63.10 | $77.62 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $549.54 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $436.52 | $549.54 | $562.34 |
Where Missouri sits
The same service costs 11.0 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· 28th of 51
$1,148
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.