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 $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,071.52 | Professional | None | $724.44 | $870.96 | $1,071.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,412.54 | Professional | None | $851.14 | $1,047.13 | $1,412.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $1,584.89 Typical High $2,137.96 | Professional | 50 · Both sides | $1,288.25 | $1,584.89 | $2,137.96 |
BCBS Kansas City Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $1,122.02 | Professional | None | $794.33 | $851.14 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,951.21 Typical High $4,365.16 | Facility | None | $645.65 | $2,951.21 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $977.24 Typical High $1,778.28 | Professional | None | $707.95 | $977.24 | $1,778.28 |
Medica Setting Facility Modifier None Typical Low $1,071.52 Median $4,365.16 Typical High $26,302.68 | Facility | None | $1,071.52 | $4,365.16 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $870.96 Median $1,513.56 Typical High $7,943.28 | Professional | None | $870.96 | $1,513.56 | $7,943.28 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,981.07 | $8,709.64 |
United Setting Professional Modifier None Typical Low $776.25 Median $1,122.02 Typical High $1,698.24 | Professional | None | $776.25 | $1,122.02 | $1,698.24 |
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 $363.08 Median $426.58 Typical High $478.63 | Professional | 52 · Reduced service | $363.08 | $426.58 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $173.78 Typical High $190.55 | Professional | 53 · Discontinued | $144.54 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $645.65 Typical High $724.44 | Professional | 54 · Surgery only | $549.54 | $645.65 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $128.82 Typical High $144.54 | Professional | 55 · Aftercare only | $109.65 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $87.10 Typical High $95.50 | Professional | 56 · Pre-op care only | $72.44 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $602.56 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $512.86 | $602.56 | $676.08 |
Where Missouri sits
The same service costs 20.9 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· 31st of 51
$1,122
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.