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 $1,819.70 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,819.70 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $1,819.70 Median $2,187.76 Typical High $2,570.40 | Professional | None | $1,819.70 | $2,187.76 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $11,481.54 | Facility | None | $1,412.54 | $3,801.89 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,187.76 Median $2,884.03 Typical High $3,981.07 | Professional | None | $2,187.76 | $2,884.03 | $3,981.07 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $1,380.38 Median $1,819.70 Typical High $2,511.89 | Professional | 62 · Two surgeons | $1,380.38 | $1,819.70 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $346.74 Median $457.09 Typical High $630.96 | Professional | 80 · Assistant surgeon | $346.74 | $457.09 | $630.96 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $309.03 Median $407.38 Typical High $549.54 | Professional | AS · PA/NP assist | $309.03 | $407.38 | $549.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $2,089.30 Median $2,290.87 Typical High $3,235.94 | Professional | None | $2,089.30 | $2,290.87 | $3,235.94 |
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 $2,290.87 Median $2,511.89 Typical High $4,786.30 | Professional | None | $2,290.87 | $2,511.89 | $4,786.30 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,380.38 Typical High $11,220.18 | Facility | None | $54.95 | $1,380.38 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $2,570.40 Median $4,897.79 Typical High $16,982.44 | Professional | None | $2,570.40 | $4,897.79 | $16,982.44 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,290.87 Typical High $10,964.78 | Facility | None | $467.74 | $2,290.87 | $10,964.78 |
United Setting Professional Modifier None Typical Low $2,344.23 Median $3,235.94 Typical High $5,888.44 | Professional | None | $2,344.23 | $3,235.94 | $5,888.44 |
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 $912.01 Median $1,096.48 Typical High $1,122.02 | Professional | 52 · Reduced service | $912.01 | $1,096.48 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $363.08 Median $436.52 Typical High $446.68 | Professional | 53 · Discontinued | $363.08 | $436.52 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,348.96 Median $1,621.81 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,348.96 | $1,621.81 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $269.15 Median $323.59 Typical High $331.13 | Professional | 55 · Aftercare only | $269.15 | $323.59 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $181.97 Median $218.78 Typical High $223.87 | Professional | 56 · Pre-op care only | $181.97 | $218.78 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,258.93 Median $1,513.56 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,258.93 | $1,513.56 | $1,548.82 |
Where Missouri sits
The same service costs 12.0 times more in Alaska than in Texas. 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· 21st of 51
$2,884
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.