How much rates vary
Facilitymedian $2,818 · 10th to 90th $1,000 to $8,913Professionalmedian $437 · 10th to 90th $282 to $2,138
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 $436.52 Median $5,623.41 Typical High $10,715.19 | Facility | None | $436.52 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $346.74 Typical High $457.09 | Professional | None | $234.42 | $346.74 | $457.09 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | 50 · Both sides | $489.78 | $489.78 | $489.78 |
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 $281.84 Median $371.54 Typical High $512.86 | Professional | None | $281.84 | $371.54 | $512.86 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $416.87 Median $549.54 Typical High $758.58 | Professional | 50 · Both sides | $416.87 | $549.54 | $758.58 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $177.83 Median $234.42 Typical High $316.23 | Professional | 62 · Two surgeons | $177.83 | $234.42 | $316.23 |
BCBS Kansas City Setting Professional Modifier None Typical Low $269.15 Median $407.38 Typical High $512.86 | Professional | None | $269.15 | $407.38 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,089.30 Typical High $3,311.31 | Facility | None | $758.58 | $2,089.30 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $407.38 Typical High $707.95 | Professional | None | $251.19 | $407.38 | $707.95 |
Medica Setting Facility Modifier None Typical Low $602.56 Median $2,344.23 Typical High $26,302.68 | Facility | None | $602.56 | $2,344.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $2,137.96 Typical High $3,162.28 | Professional | None | $478.63 | $2,137.96 | $3,162.28 |
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 $295.12 Median $446.68 Typical High $676.08 | Professional | None | $295.12 | $446.68 | $676.08 |
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 $117.49 Median $173.78 Typical High $213.80 | Professional | 52 · Reduced service | $117.49 | $173.78 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $69.18 Typical High $87.10 | Professional | 53 · Discontinued | $46.77 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $263.03 Typical High $323.59 | Professional | 54 · Surgery only | $177.83 | $263.03 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $52.48 Typical High $64.57 | Professional | 55 · Aftercare only | $35.48 | $52.48 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $34.67 Typical High $43.65 | Professional | 56 · Pre-op care only | $23.44 | $34.67 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $245.47 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $165.96 | $245.47 | $302.00 |
Where Missouri sits
The same service costs 5.9 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· 28th of 51
$468
AK $1,413UT $240
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.