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 $478.63 Median $707.95 Typical High $812.83 | Professional | None | $478.63 | $707.95 | $812.83 |
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 $1,071.52 | Professional | None | $660.69 | $831.76 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $416.87 Median $524.81 Typical High $676.08 | Professional | 62 · Two surgeons | $416.87 | $524.81 | $676.08 |
BCBS Kansas City Setting Professional Modifier None Typical Low $676.08 Median $724.44 Typical High $977.24 | Professional | None | $676.08 | $724.44 | $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 $602.56 Median $794.33 Typical High $1,445.44 | Professional | None | $602.56 | $794.33 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $2,754.23 Typical High $26,302.68 | Facility | None | $933.25 | $2,754.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $724.44 Median $1,288.25 Typical High $5,495.41 | Professional | None | $724.44 | $1,288.25 | $5,495.41 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $645.65 Median $912.01 Typical High $1,412.54 | Professional | None | $645.65 | $912.01 | $1,412.54 |
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 $147.91 Typical High $162.18 | Professional | 53 · Discontinued | $123.03 | $147.91 | $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 6.6 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
$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.