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 $1,698.24 Median $5,623.41 Typical High $10,715.19 | Facility | None | $1,698.24 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,071.52 | Professional | None | $741.31 | $870.96 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $1,621.81 | Professional | None | $870.96 | $1,148.15 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $549.54 Median $724.44 Typical High $1,023.29 | Professional | 62 · Two surgeons | $549.54 | $724.44 | $1,023.29 |
BCBS Kansas City Setting Professional Modifier None Typical Low $912.01 Median $977.24 Typical High $1,202.26 | Professional | None | $912.01 | $977.24 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,398.83 Typical High $3,311.31 | Facility | None | $758.58 | $2,398.83 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,023.29 Typical High $2,041.74 | Professional | None | $831.76 | $1,023.29 | $2,041.74 |
Medica Setting Facility Modifier None Typical Low $1,071.52 Median $3,801.89 Typical High $26,302.68 | Facility | None | $1,071.52 | $3,801.89 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $1,905.46 Typical High $7,413.10 | Professional | None | $851.14 | $1,905.46 | $7,413.10 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,467.37 | $6,918.31 |
United Setting Professional Modifier None Typical Low $831.76 Median $1,202.26 Typical High $1,905.46 | Professional | None | $831.76 | $1,202.26 | $1,905.46 |
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 $371.54 Median $436.52 Typical High $489.78 | Professional | 52 · Reduced service | $371.54 | $436.52 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $173.78 Typical High $194.98 | Professional | 53 · Discontinued | $147.91 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $562.34 Median $660.69 Typical High $724.44 | Professional | 54 · Surgery only | $562.34 | $660.69 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $131.83 Typical High $144.54 | Professional | 55 · Aftercare only | $112.20 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $87.10 Typical High $97.72 | Professional | 56 · Pre-op care only | $74.13 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $524.81 Median $616.60 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $524.81 | $616.60 | $676.08 |
Where Missouri sits
The same service costs 8.3 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· 24th of 51
$1,288
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.