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 $1,148.15 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,148.15 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $1,412.54 | Professional | None | $398.11 | $478.63 | $1,412.54 |
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 $489.78 Median $616.60 Typical High $891.25 | Professional | None | $489.78 | $616.60 | $891.25 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $79.43 Median $97.72 Typical High $141.25 | Professional | 80 · Assistant surgeon | $79.43 | $97.72 | $141.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $69.18 Median $85.11 Typical High $125.89 | Professional | AS · PA/NP assist | $69.18 | $85.11 | $125.89 |
BCBS Kansas City Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $724.44 | Professional | None | $467.74 | $524.81 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $245.47 Typical High $1,659.59 | Facility | None | $165.96 | $245.47 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $1,174.90 | Professional | None | $501.19 | $588.84 | $1,174.90 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $501.19 Typical High $4,168.69 | Facility | None | $54.95 | $501.19 | $4,168.69 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $977.24 Typical High $3,715.35 | Professional | None | $478.63 | $977.24 | $3,715.35 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,137.96 | Facility | None | $123.03 | $602.56 | $2,137.96 |
United Setting Professional Modifier None Typical Low $467.74 Median $630.96 Typical High $977.24 | Professional | None | $467.74 | $630.96 | $977.24 |
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 $199.53 Median $239.88 Typical High $245.47 | Professional | 52 · Reduced service | $199.53 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $95.50 Typical High $97.72 | Professional | 53 · Discontinued | $79.43 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $354.81 Typical High $363.08 | Professional | 54 · Surgery only | $295.12 | $354.81 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $72.44 Typical High $74.13 | Professional | 55 · Aftercare only | $60.26 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $47.86 Typical High $48.98 | Professional | 56 · Pre-op care only | $39.81 | $47.86 | $48.98 |
Where Missouri sits
The same service costs 3.2 times more in Alaska than in Arkansas. 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
$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.