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 $2,089.30 Median $5,623.41 Typical High $8,709.64 | Facility | None | $2,089.30 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $616.60 Median $724.44 Typical High $1,122.02 | Professional | None | $616.60 | $724.44 | $1,122.02 |
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 $660.69 Median $758.58 Typical High $1,174.90 | Professional | None | $660.69 | $758.58 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,122.02 Typical High $1,737.80 | Professional | 50 · Both sides | $977.24 | $1,122.02 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $407.38 Median $478.63 Typical High $741.31 | Professional | 62 · Two surgeons | $407.38 | $478.63 | $741.31 |
BCBS Kansas City Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $954.99 | Professional | None | $676.08 | $724.44 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,511.89 Typical High $3,019.95 | Facility | None | $707.95 | $2,511.89 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $776.25 Typical High $1,348.96 | Professional | None | $602.56 | $776.25 | $1,348.96 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $3,019.95 Typical High $7,585.78 | Facility | None | $54.95 | $3,019.95 | $7,585.78 |
Medica Setting Professional Modifier None Typical Low $707.95 Median $1,174.90 Typical High $5,370.32 | Professional | None | $707.95 | $1,174.90 | $5,370.32 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,570.88 Typical High $12,302.69 | Facility | None | $977.24 | $4,570.88 | $12,302.69 |
United Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,445.44 | Professional | None | $630.96 | $851.14 | $1,445.44 |
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 $302.00 Median $363.08 Typical High $398.11 | Professional | 52 · Reduced service | $302.00 | $363.08 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $123.03 Median $144.54 Typical High $162.18 | Professional | 53 · Discontinued | $123.03 | $144.54 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $549.54 Typical High $602.56 | Professional | 54 · Surgery only | $457.09 | $549.54 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $109.65 Typical High $120.23 | Professional | 55 · Aftercare only | $91.20 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $72.44 Typical High $81.28 | Professional | 56 · Pre-op care only | $61.66 | $72.44 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $512.86 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $426.58 | $512.86 | $562.34 |
Where Missouri sits
The same service costs 7.6 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
$832
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.