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 $5,623.41 Typical High $10,715.19 | Facility | None | $1,698.24 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $954.99 | Professional | None | $562.34 | $676.08 | $954.99 |
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 $831.76 Typical High $1,122.02 | Professional | None | $660.69 | $831.76 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $977.24 Median $1,230.27 Typical High $1,659.59 | Professional | 50 · Both sides | $977.24 | $1,230.27 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $524.81 Typical High $707.95 | Professional | 62 · Two surgeons | $416.87 | $524.81 | $707.95 |
BCBS Kansas City Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $891.25 | Professional | None | $616.60 | $660.69 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,630.78 Typical High $5,370.32 | Facility | None | $707.95 | $3,630.78 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $707.95 Typical High $1,348.96 | Professional | None | $562.34 | $707.95 | $1,348.96 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,187.76 Typical High $19,952.62 | Facility | None | $54.95 | $2,187.76 | $19,952.62 |
Medica Setting Professional Modifier None Typical Low $660.69 Median $1,122.02 Typical High $5,754.40 | Professional | None | $660.69 | $1,122.02 | $5,754.40 |
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 $588.84 Median $831.76 Typical High $1,318.26 | Professional | None | $588.84 | $831.76 | $1,318.26 |
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 $281.84 Median $338.84 Typical High $371.54 | Professional | 52 · Reduced service | $281.84 | $338.84 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $134.90 Typical High $147.91 | Professional | 53 · Discontinued | $112.20 | $134.90 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $501.19 Typical High $562.34 | Professional | 54 · Surgery only | $426.58 | $501.19 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $102.33 Typical High $112.20 | Professional | 55 · Aftercare only | $85.11 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $67.61 Typical High $74.13 | Professional | 56 · Pre-op care only | $56.23 | $67.61 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $467.74 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $398.11 | $467.74 | $524.81 |
Where Missouri sits
The same service costs 8.1 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
$871
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.