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 $1,862.09 Median $5,623.41 Typical High $11,481.54 | Facility | None | $1,862.09 | $5,623.41 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,698.24 Typical High $2,570.40 | Professional | None | $1,412.54 | $1,698.24 | $2,570.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $5,370.32 Typical High $16,982.44 | Facility | None | $1,412.54 | $5,370.32 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,778.28 Median $2,089.30 Typical High $2,818.38 | Professional | None | $1,778.28 | $2,089.30 | $2,818.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,630.27 Median $3,162.28 Typical High $4,265.80 | Professional | 50 · Both sides | $2,630.27 | $3,162.28 | $4,265.80 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,513.56 Median $1,621.81 Typical High $2,187.76 | Professional | None | $1,513.56 | $1,621.81 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $5,248.07 Typical High $10,471.29 | Facility | None | $851.14 | $5,248.07 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,819.70 Typical High $3,467.37 | Professional | None | $1,380.38 | $1,819.70 | $3,467.37 |
Medica Setting Facility Modifier None Typical Low $1,412.54 Median $6,025.60 Typical High $33,884.42 | Facility | None | $1,412.54 | $6,025.60 | $33,884.42 |
Medica Setting Professional Modifier None Typical Low $1,698.24 Median $2,818.38 Typical High $12,589.25 | Professional | None | $1,698.24 | $2,818.38 | $12,589.25 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $5,248.07 Typical High $13,489.63 | Facility | None | $1,174.90 | $5,248.07 | $13,489.63 |
United Setting Professional Modifier None Typical Low $1,479.11 Median $2,137.96 Typical High $3,311.31 | Professional | None | $1,479.11 | $2,137.96 | $3,311.31 |
4 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 54 · Surgery only Typical Low $1,047.13 Median $1,258.93 Typical High $1,380.38 | Professional | 54 · Surgery only | $1,047.13 | $1,258.93 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $251.19 Typical High $275.42 | Professional | 55 · Aftercare only | $208.93 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $169.82 Typical High $186.21 | Professional | 56 · Pre-op care only | $141.25 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $1,174.90 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $977.24 | $1,174.90 | $1,288.25 |
Where Missouri sits
The same service costs 7.8 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· 27th of 51
$2,239
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.