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 $426.58 Median $3,162.28 Typical High $7,762.47 | Facility | None | $426.58 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $371.54 Typical High $588.84 | Professional | None | $302.00 | $371.54 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $1,621.81 Typical High $3,890.45 | Facility | None | $151.36 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $562.34 | Professional | None | $323.59 | $363.08 | $562.34 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $549.54 Typical High $831.76 | Professional | 50 · Both sides | $489.78 | $549.54 | $831.76 |
BCBS Kansas City Setting Professional Modifier None Typical Low $363.08 Median $426.58 Typical High $549.54 | Professional | None | $363.08 | $426.58 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $199.53 Typical High $1,659.59 | Facility | None | $134.90 | $199.53 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $707.95 | Professional | None | $302.00 | $407.38 | $707.95 |
Medica Setting Facility Modifier None Typical Low $151.36 Median $660.69 Typical High $12,022.64 | Facility | None | $151.36 | $660.69 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $416.87 Median $2,691.53 Typical High $2,951.21 | Professional | None | $416.87 | $2,691.53 | $2,951.21 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,137.96 | Facility | None | $123.03 | $602.56 | $2,137.96 |
United Setting Professional Modifier None Typical Low $323.59 Median $436.52 Typical High $741.31 | Professional | None | $323.59 | $436.52 | $741.31 |
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 $151.36 Median $181.97 Typical High $204.17 | Professional | 52 · Reduced service | $151.36 | $181.97 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $72.44 Typical High $83.18 | Professional | 53 · Discontinued | $60.26 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $275.42 Typical High $309.03 | Professional | 54 · Surgery only | $229.09 | $275.42 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $54.95 Typical High $61.66 | Professional | 55 · Aftercare only | $45.71 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $36.31 Typical High $41.69 | Professional | 56 · Pre-op care only | $30.20 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $257.04 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $213.80 | $257.04 | $288.40 |
Where Missouri sits
The same service costs 5.1 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· 32nd of 51
$427
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.