How much rates vary
Facilitymedian $2,692 · 10th to 90th $331 to $6,761Professionalmedian $589 · 10th to 90th $347 to $1,660
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 $446.68 Median $4,570.88 Typical High $7,762.47 | Facility | None | $446.68 | $4,570.88 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $446.68 Typical High $794.33 | Professional | None | $281.84 | $446.68 | $794.33 |
Ambetter Setting Professional Modifier None Typical Low $275.42 Median $281.84 Typical High $1,000.00 | Professional | None | $275.42 | $281.84 | $1,000.00 |
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 $436.52 Median $549.54 Typical High $831.76 | Professional | None | $436.52 | $549.54 | $831.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $831.76 Typical High $1,230.27 | Professional | 50 · Both sides | $660.69 | $831.76 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $275.42 Median $346.74 Typical High $524.81 | Professional | 62 · Two surgeons | $275.42 | $346.74 | $524.81 |
BCBS Setting Professional Modifier None Typical Low $257.04 Median $407.38 Typical High $575.44 | Professional | None | $257.04 | $407.38 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $331.13 Typical High $2,691.53 | Facility | None | $218.78 | $331.13 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $537.03 Typical High $1,000.00 | Professional | None | $263.03 | $537.03 | $1,000.00 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,737.80 Typical High $4,677.35 | Facility | None | $54.95 | $1,737.80 | $4,677.35 |
Medica Setting Professional Modifier None Typical Low $676.08 Median $2,454.71 Typical High $3,630.78 | Professional | None | $676.08 | $2,454.71 | $3,630.78 |
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 $398.11 Median $691.83 Typical High $1,230.27 | Professional | None | $398.11 | $691.83 | $1,230.27 |
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 $141.25 Median $223.87 Typical High $263.03 | Professional | 52 · Reduced service | $141.25 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $89.13 Typical High $104.71 | Professional | 53 · Discontinued | $56.23 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $331.13 Typical High $398.11 | Professional | 54 · Surgery only | $208.93 | $331.13 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $66.07 Typical High $79.43 | Professional | 55 · Aftercare only | $41.69 | $66.07 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $44.67 Typical High $52.48 | Professional | 56 · Pre-op care only | $28.18 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $309.03 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $194.98 | $309.03 | $371.54 |
Where Missouri sits
The same service costs 4.1 times more in Wisconsin 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· 18th of 51
$676
WI $1,549TX $380
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.