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 $478.63 Median $575.44 Typical High $676.08 | Professional | None | $478.63 | $575.44 | $676.08 |
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 $562.34 Median $660.69 Typical High $933.25 | Professional | None | $562.34 | $660.69 | $933.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,000.00 Typical High $1,380.38 | Professional | 50 · Both sides | $831.76 | $1,000.00 | $1,380.38 |
BCBS Kansas City Setting Professional Modifier None Typical Low $537.03 Median $575.44 Typical High $758.58 | Professional | None | $537.03 | $575.44 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,290.87 Typical High $3,311.31 | Facility | None | $602.56 | $2,290.87 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $1,148.15 | Professional | None | $478.63 | $602.56 | $1,148.15 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $3,715.35 Typical High $16,218.10 | Facility | None | $724.44 | $3,715.35 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $562.34 Median $954.99 Typical High $4,265.80 | Professional | None | $562.34 | $954.99 | $4,265.80 |
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 $501.19 Median $691.83 Typical High $1,122.02 | Professional | None | $501.19 | $691.83 | $1,122.02 |
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 $239.88 Median $288.40 Typical High $316.23 | Professional | 52 · Reduced service | $239.88 | $288.40 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $114.82 Typical High $125.89 | Professional | 53 · Discontinued | $95.50 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $436.52 Typical High $478.63 | Professional | 54 · Surgery only | $363.08 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $87.10 Typical High $95.50 | Professional | 55 · Aftercare only | $72.44 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $57.54 Typical High $63.10 | Professional | 56 · Pre-op care only | $47.86 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $407.38 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $338.84 | $407.38 | $446.68 |
Where Missouri sits
The same service costs 7.9 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· 34th of 51
$692
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.