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 $616.60 Median $741.31 Typical High $870.96 | Professional | None | $616.60 | $741.31 | $870.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,467.37 Typical High $6,606.93 | Facility | None | $1,288.25 | $3,467.37 | $6,606.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $691.83 Median $831.76 Typical High $1,174.90 | Professional | None | $691.83 | $831.76 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,258.93 Typical High $1,778.28 | Professional | 50 · Both sides | $1,047.13 | $1,258.93 | $1,778.28 |
BCBS Kansas City Setting Professional Modifier None Typical Low $691.83 Median $741.31 Typical High $977.24 | Professional | None | $691.83 | $741.31 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,089.30 Typical High $2,691.53 | Facility | None | $645.65 | $2,089.30 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $794.33 Typical High $1,445.44 | Professional | None | $616.60 | $794.33 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,754.23 Typical High $8,912.51 | Facility | None | $54.95 | $2,754.23 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $724.44 Median $1,202.26 Typical High $5,495.41 | Professional | None | $724.44 | $1,202.26 | $5,495.41 |
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 $645.65 Median $891.25 Typical High $1,479.11 | Professional | None | $645.65 | $891.25 | $1,479.11 |
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 $309.03 Median $371.54 Typical High $407.38 | Professional | 52 · Reduced service | $309.03 | $371.54 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $147.91 Typical High $162.18 | Professional | 53 · Discontinued | $125.89 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $562.34 Typical High $616.60 | Professional | 54 · Surgery only | $467.74 | $562.34 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $112.20 Typical High $123.03 | Professional | 55 · Aftercare only | $93.33 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $74.13 Typical High $81.28 | Professional | 56 · Pre-op care only | $61.66 | $74.13 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $524.81 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $436.52 | $524.81 | $575.44 |
Where Missouri sits
The same service costs 7.8 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· 28th of 51
$933
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.