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 $380.19 Median $3,235.94 Typical High $6,309.57 | Facility | None | $380.19 | $3,235.94 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $363.08 Typical High $501.19 | Professional | None | $263.03 | $363.08 | $501.19 |
Ambetter Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $371.54 Typical High $537.03 | Professional | None | $302.00 | $371.54 | $537.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $457.09 Median $562.34 Typical High $794.33 | Professional | 50 · Both sides | $457.09 | $562.34 | $794.33 |
BCBS Kansas City Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $562.34 | Professional | None | $302.00 | $457.09 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $954.99 Typical High $2,187.76 | Facility | None | $602.56 | $954.99 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $457.09 Typical High $707.95 | Professional | None | $257.04 | $457.09 | $707.95 |
Medica Setting Facility Modifier None Typical Low $512.86 Median $1,479.11 Typical High $16,218.10 | Facility | None | $512.86 | $1,479.11 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $501.19 Median $2,344.23 Typical High $3,388.44 | Professional | None | $501.19 | $2,344.23 | $3,388.44 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,235.94 | Facility | None | $562.34 | $1,513.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $741.31 | Professional | None | $316.23 | $489.78 | $741.31 |
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 $131.83 Median $190.55 Typical High $234.42 | Professional | 52 · Reduced service | $131.83 | $190.55 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $75.86 Typical High $95.50 | Professional | 53 · Discontinued | $52.48 | $75.86 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $288.40 Typical High $354.81 | Professional | 54 · Surgery only | $194.98 | $288.40 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $57.54 Typical High $70.79 | Professional | 55 · Aftercare only | $38.90 | $57.54 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $38.02 Typical High $47.86 | Professional | 56 · Pre-op care only | $26.30 | $38.02 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $269.15 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $181.97 | $269.15 | $331.13 |
Where Missouri sits
The same service costs 4.9 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· 34th of 51
$457
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.