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 $1,548.82 Median $3,981.07 Typical High $7,762.47 | Facility | None | $1,548.82 | $3,981.07 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $588.84 Typical High $741.31 | Professional | None | $489.78 | $588.84 | $741.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,288.25 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $776.25 Typical High $1,174.90 | Professional | None | $616.60 | $776.25 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $489.78 Typical High $741.31 | Professional | 62 · Two surgeons | $389.05 | $489.78 | $741.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $97.72 Median $125.89 Typical High $186.21 | Professional | 80 · Assistant surgeon | $97.72 | $125.89 | $186.21 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $85.11 Median $109.65 Typical High $162.18 | Professional | AS · PA/NP assist | $85.11 | $109.65 | $162.18 |
BCBS Kansas City Setting Professional Modifier None Typical Low $512.86 Median $562.34 Typical High $776.25 | Professional | None | $512.86 | $562.34 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,137.96 Typical High $2,691.53 | Facility | None | $512.86 | $2,137.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $1,202.26 | Professional | None | $489.78 | $645.65 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $131.83 Median $741.31 Typical High $16,218.10 | Facility | None | $131.83 | $741.31 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $1,096.48 Typical High $4,265.80 | Professional | None | $645.65 | $1,096.48 | $4,265.80 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $2,137.96 | Facility | None | $123.03 | $549.54 | $2,137.96 |
United Setting Professional Modifier None Typical Low $537.03 Median $1,000.00 Typical High $1,258.93 | Professional | None | $537.03 | $1,000.00 | $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 $245.47 Median $295.12 Typical High $302.00 | Professional | 52 · Reduced service | $245.47 | $295.12 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $117.49 Typical High $120.23 | Professional | 53 · Discontinued | $97.72 | $117.49 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $436.52 Typical High $457.09 | Professional | 54 · Surgery only | $371.54 | $436.52 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $87.10 Typical High $91.20 | Professional | 55 · Aftercare only | $74.13 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $58.88 Typical High $60.26 | Professional | 56 · Pre-op care only | $48.98 | $58.88 | $60.26 |
Where Missouri sits
The same service costs 4.9 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· 16th of 51
$891
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.