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 $602.56 Median $691.83 Typical High $2,511.89 | Professional | None | $602.56 | $691.83 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,762.47 | Facility | None | $1,318.26 | $3,467.37 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $616.60 Median $933.25 Typical High $1,318.26 | Professional | None | $616.60 | $933.25 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $933.25 Median $1,412.54 Typical High $1,949.84 | Professional | 50 · Both sides | $933.25 | $1,412.54 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $389.05 Median $588.84 Typical High $831.76 | Professional | 62 · Two surgeons | $389.05 | $588.84 | $831.76 |
BCBS Kansas City Setting Professional Modifier None Typical Low $549.54 Median $588.84 Typical High $831.76 | Professional | None | $549.54 | $588.84 | $831.76 |
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 $549.54 Median $758.58 Typical High $1,348.96 | Professional | None | $549.54 | $758.58 | $1,348.96 |
Medica Setting Facility Modifier None Typical Low $891.25 Median $3,715.35 Typical High $26,302.68 | Facility | None | $891.25 | $3,715.35 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $812.83 Median $1,548.82 Typical High $6,456.54 | Professional | None | $812.83 | $1,548.82 | $6,456.54 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,467.37 | $6,918.31 |
United Setting Professional Modifier None Typical Low $660.69 Median $1,047.13 Typical High $1,737.80 | Professional | None | $660.69 | $1,047.13 | $1,737.80 |
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 $346.74 Typical High $371.54 | Professional | 52 · Reduced service | $302.00 | $346.74 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $138.04 Typical High $147.91 | Professional | 53 · Discontinued | $120.23 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $457.09 Median $524.81 Typical High $562.34 | Professional | 54 · Surgery only | $457.09 | $524.81 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $104.71 Typical High $112.20 | Professional | 55 · Aftercare only | $91.20 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $69.18 Typical High $74.13 | Professional | 56 · Pre-op care only | $60.26 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $426.58 Median $489.78 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $426.58 | $489.78 | $524.81 |
Where Missouri sits
The same service costs 5.9 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· 20th of 51
$1,122
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.