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 $562.34 Median $676.08 Typical High $851.14 | Professional | None | $562.34 | $676.08 | $851.14 |
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 $707.95 Median $912.01 Typical High $1,348.96 | Professional | None | $707.95 | $912.01 | $1,348.96 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $575.44 Typical High $851.14 | Professional | 62 · Two surgeons | $446.68 | $575.44 | $851.14 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $114.82 Median $144.54 Typical High $218.78 | Professional | 80 · Assistant surgeon | $114.82 | $144.54 | $218.78 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $100.00 Median $125.89 Typical High $190.55 | Professional | AS · PA/NP assist | $100.00 | $125.89 | $190.55 |
BCBS Kansas City Setting Professional Modifier None Typical Low $602.56 Median $645.65 Typical High $891.25 | Professional | None | $602.56 | $645.65 | $891.25 |
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 $562.34 Median $741.31 Typical High $1,380.38 | Professional | None | $562.34 | $741.31 | $1,380.38 |
Medica Setting Facility Modifier None Typical Low $131.83 Median $758.58 Typical High $16,218.10 | Facility | None | $131.83 | $758.58 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $741.31 Median $1,288.25 Typical High $5,011.87 | Professional | None | $741.31 | $1,288.25 | $5,011.87 |
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 $616.60 Median $1,148.15 Typical High $1,445.44 | Professional | None | $616.60 | $1,148.15 | $1,445.44 |
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 $281.84 Median $338.84 Typical High $346.74 | Professional | 52 · Reduced service | $281.84 | $338.84 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $134.90 Typical High $141.25 | Professional | 53 · Discontinued | $114.82 | $134.90 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $512.86 Typical High $524.81 | Professional | 54 · Surgery only | $426.58 | $512.86 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $102.33 Typical High $104.71 | Professional | 55 · Aftercare only | $85.11 | $102.33 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $67.61 Typical High $70.79 | Professional | 56 · Pre-op care only | $56.23 | $67.61 | $70.79 |
Where Missouri sits
The same service costs 4.7 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· 17th of 51
$1,000
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.