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 $537.03 Median $4,897.79 Typical High $7,762.47 | Facility | None | $537.03 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $467.74 Typical High $549.54 | Professional | None | $389.05 | $467.74 | $549.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,548.13 Typical High $8,128.31 | Facility | None | $1,412.54 | $3,548.13 | $8,128.31 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $891.25 | Professional | None | $478.63 | $645.65 | $891.25 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $302.00 Median $407.38 Typical High $549.54 | Professional | 62 · Two surgeons | $302.00 | $407.38 | $549.54 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $75.86 Median $104.71 Typical High $141.25 | Professional | 80 · Assistant surgeon | $75.86 | $104.71 | $141.25 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $66.07 Median $91.20 Typical High $123.03 | Professional | AS · PA/NP assist | $66.07 | $91.20 | $123.03 |
BCBS Kansas City Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $660.69 | Professional | None | $407.38 | $467.74 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $2,137.96 Typical High $2,691.53 | Facility | None | $588.84 | $2,137.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $537.03 Typical High $1,071.52 | Professional | None | $501.19 | $537.03 | $1,071.52 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,096.48 Typical High $7,585.78 | Facility | None | $54.95 | $1,096.48 | $7,585.78 |
Medica Setting Professional Modifier None Typical Low $562.34 Median $1,071.52 Typical High $3,388.44 | Professional | None | $562.34 | $1,071.52 | $3,388.44 |
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 $489.78 Median $707.95 Typical High $1,258.93 | Professional | None | $489.78 | $707.95 | $1,258.93 |
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 $234.42 Typical High $239.88 | Professional | 52 · Reduced service | $194.98 | $234.42 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $93.33 Typical High $95.50 | Professional | 53 · Discontinued | $77.62 | $93.33 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $346.74 Typical High $363.08 | Professional | 54 · Surgery only | $295.12 | $346.74 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $70.79 Typical High $72.44 | Professional | 55 · Aftercare only | $58.88 | $70.79 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $46.77 Typical High $47.86 | Professional | 56 · Pre-op care only | $38.90 | $46.77 | $47.86 |
Where Missouri sits
The same service costs 4.3 times more in Alaska 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· 13th of 51
$759
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.