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 $501.19 Median $602.56 Typical High $912.01 | Professional | None | $501.19 | $602.56 | $912.01 |
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 $645.65 Typical High $954.99 | Professional | None | $562.34 | $645.65 | $954.99 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $851.14 Median $977.24 Typical High $1,445.44 | Professional | 50 · Both sides | $851.14 | $977.24 | $1,445.44 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $354.81 Median $407.38 Typical High $602.56 | Professional | 62 · Two surgeons | $354.81 | $407.38 | $602.56 |
BCBS Kansas City Setting Professional Modifier None Typical Low $562.34 Median $602.56 Typical High $776.25 | Professional | None | $562.34 | $602.56 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,187.76 Typical High $3,019.95 | Facility | None | $602.56 | $2,187.76 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $1,202.26 | Professional | None | $501.19 | $630.96 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $812.83 Median $3,715.35 Typical High $16,218.10 | Facility | None | $812.83 | $3,715.35 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $588.84 Median $1,023.29 Typical High $6,456.54 | Professional | None | $588.84 | $1,023.29 | $6,456.54 |
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 $524.81 Median $741.31 Typical High $1,174.90 | Professional | None | $524.81 | $741.31 | $1,174.90 |
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 $251.19 Median $302.00 Typical High $331.13 | Professional | 52 · Reduced service | $251.19 | $302.00 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $120.23 Typical High $131.83 | Professional | 53 · Discontinued | $100.00 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $446.68 Typical High $489.78 | Professional | 54 · Surgery only | $371.54 | $446.68 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $89.13 Typical High $100.00 | Professional | 55 · Aftercare only | $75.86 | $89.13 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $60.26 Typical High $66.07 | Professional | 56 · Pre-op care only | $50.12 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $416.87 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $346.74 | $416.87 | $457.09 |
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.