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 $1,096.48 Median $3,715.35 Typical High $7,762.47 | Facility | None | $1,096.48 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $1,288.25 | Professional | None | $389.05 | $478.63 | $1,288.25 |
Ambetter Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $645.65 Typical High $831.76 | Professional | None | $501.19 | $645.65 | $831.76 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $316.23 Median $407.38 Typical High $524.81 | Professional | 62 · Two surgeons | $316.23 | $407.38 | $524.81 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $81.28 Median $104.71 Typical High $134.90 | Professional | 80 · Assistant surgeon | $81.28 | $104.71 | $134.90 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $70.79 Median $91.20 Typical High $117.49 | Professional | AS · PA/NP assist | $70.79 | $91.20 | $117.49 |
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 $512.86 Median $537.03 Typical High $1,122.02 | Professional | None | $512.86 | $537.03 | $1,122.02 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $380.19 Typical High $2,041.74 | Facility | None | $54.95 | $380.19 | $2,041.74 |
Medica Setting Professional Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $3,981.07 | Professional | None | $3,981.07 | $3,981.07 | $3,981.07 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $3,388.44 | Facility | None | $123.03 | $602.56 | $3,388.44 |
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 $194.98 Median $239.88 Typical High $245.47 | Professional | 52 · Reduced service | $194.98 | $239.88 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $95.50 Typical High $100.00 | Professional | 53 · Discontinued | $79.43 | $95.50 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $363.08 Typical High $371.54 | Professional | 54 · Surgery only | $295.12 | $363.08 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $72.44 Typical High $74.13 | Professional | 55 · Aftercare only | $58.88 | $72.44 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $47.86 Typical High $50.12 | Professional | 56 · Pre-op care only | $38.90 | $47.86 | $50.12 |
Where Missouri sits
The same service costs 134.9 times more in Oklahoma than in Hawaii. 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· 18th of 51
$708
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.