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 $1,412.54 Median $5,495.41 Typical High $11,481.54 | Facility | None | $1,412.54 | $5,495.41 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $1,548.82 | Professional | None | $537.03 | $645.65 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,513.56 Median $6,165.95 Typical High $16,982.44 | Facility | None | $1,513.56 | $6,165.95 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $660.69 Median $776.25 Typical High $1,288.25 | Professional | None | $660.69 | $776.25 | $1,288.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,000.00 Median $1,174.90 Typical High $1,905.46 | Professional | 50 · Both sides | $1,000.00 | $1,174.90 | $1,905.46 |
BCBS Setting Professional Modifier None Typical Low $602.56 Median $645.65 Typical High $851.14 | Professional | None | $602.56 | $645.65 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $2,290.87 Typical High $10,471.29 | Facility | None | $1,096.48 | $2,290.87 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $1,318.26 | Professional | None | $537.03 | $691.83 | $1,318.26 |
Medica Setting Facility Modifier None Typical Low $851.14 Median $3,801.89 Typical High $26,302.68 | Facility | None | $851.14 | $3,801.89 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $630.96 Median $1,071.52 Typical High $5,128.61 | Professional | None | $630.96 | $1,071.52 | $5,128.61 |
United Setting Facility Modifier None Typical Low $1,096.48 Median $3,801.89 Typical High $9,120.11 | Facility | None | $1,096.48 | $3,801.89 | $9,120.11 |
United Setting Professional Modifier None Typical Low $562.34 Median $794.33 Typical High $1,258.93 | Professional | None | $562.34 | $794.33 | $1,258.93 |
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 $269.15 Median $323.59 Typical High $354.81 | Professional | 52 · Reduced service | $269.15 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $128.82 Typical High $141.25 | Professional | 53 · Discontinued | $107.15 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $489.78 Typical High $537.03 | Professional | 54 · Surgery only | $407.38 | $489.78 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $97.72 Typical High $107.15 | Professional | 55 · Aftercare only | $81.28 | $97.72 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $64.57 Typical High $70.79 | Professional | 56 · Pre-op care only | $53.70 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $457.09 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $380.19 | $457.09 | $501.19 |
Where Missouri sits
The same service costs 7.4 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· 26th of 51
$851
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.