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 $309.03 Median $3,715.35 Typical High $8,709.64 | Facility | None | $309.03 | $3,715.35 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $208.93 Typical High $295.12 | Professional | None | $162.18 | $208.93 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $204.17 Median $3,467.37 Typical High $7,079.46 | Facility | None | $204.17 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $239.88 Median $323.59 Typical High $467.74 | Professional | None | $239.88 | $323.59 | $467.74 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $151.36 Median $204.17 Typical High $288.40 | Professional | 62 · Two surgeons | $151.36 | $204.17 | $288.40 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $38.02 Median $52.48 Typical High $74.13 | Professional | 80 · Assistant surgeon | $38.02 | $52.48 | $74.13 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $33.11 Median $45.71 Typical High $66.07 | Professional | AS · PA/NP assist | $33.11 | $45.71 | $66.07 |
BCBS Kansas City Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $354.81 | Professional | None | $194.98 | $263.03 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $380.19 Typical High $3,801.89 | Facility | None | $165.96 | $380.19 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $295.12 Typical High $524.81 | Professional | None | $208.93 | $295.12 | $524.81 |
Medica Setting Facility Modifier None Typical Low $151.36 Median $660.69 Typical High $12,022.64 | Facility | None | $151.36 | $660.69 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $645.65 Typical High $3,090.30 | Professional | None | $263.03 | $645.65 | $3,090.30 |
United Setting Facility Modifier None Typical Low $123.03 Median $616.60 Typical High $4,365.16 | Facility | None | $123.03 | $616.60 | $4,365.16 |
United Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $549.54 | Professional | None | $229.09 | $316.23 | $549.54 |
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 $81.28 Median $104.71 Typical High $125.89 | Professional | 52 · Reduced service | $81.28 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $41.69 Typical High $50.12 | Professional | 53 · Discontinued | $32.36 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $154.88 Typical High $190.55 | Professional | 54 · Surgery only | $123.03 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $30.90 Typical High $38.02 | Professional | 55 · Aftercare only | $24.55 | $30.90 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $20.89 Typical High $25.12 | Professional | 56 · Pre-op care only | $16.22 | $20.89 | $25.12 |
Where Missouri sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 22nd of 51
$331
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.