How much rates vary
Facilitymedian $2,692 · 10th to 90th $398 to $6,761Professionalmedian $708 · 10th to 90th $427 to $1,995
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 $524.81 Median $4,677.35 Typical High $7,762.47 | Facility | None | $524.81 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $977.24 | Professional | None | $346.74 | $524.81 | $977.24 |
Ambetter Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $1,230.27 | Professional | None | $407.38 | $478.63 | $1,230.27 |
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 $537.03 Median $676.08 Typical High $1,000.00 | Professional | None | $537.03 | $676.08 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $1,023.29 Typical High $1,479.11 | Professional | 50 · Both sides | $794.33 | $1,023.29 | $1,479.11 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $338.84 Median $426.58 Typical High $616.60 | Professional | 62 · Two surgeons | $338.84 | $426.58 | $616.60 |
BCBS Kansas City Setting Professional Modifier None Typical Low $316.23 Median $478.63 Typical High $691.83 | Professional | None | $316.23 | $478.63 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $371.54 Typical High $2,691.53 | Facility | None | $251.19 | $371.54 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $645.65 Typical High $1,202.26 | Professional | None | $323.59 | $645.65 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,819.70 Typical High $4,677.35 | Facility | None | $54.95 | $1,819.70 | $4,677.35 |
Medica Setting Professional Modifier None Typical Low $794.33 Median $2,951.21 Typical High $4,365.16 | Professional | None | $794.33 | $2,951.21 | $4,365.16 |
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 $467.74 Median $851.14 Typical High $1,445.44 | Professional | None | $467.74 | $851.14 | $1,445.44 |
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 $173.78 Median $263.03 Typical High $309.03 | Professional | 52 · Reduced service | $173.78 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $104.71 Typical High $125.89 | Professional | 53 · Discontinued | $69.18 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $389.05 Typical High $467.74 | Professional | 54 · Surgery only | $257.04 | $389.05 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $77.62 Typical High $93.33 | Professional | 55 · Aftercare only | $51.29 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $52.48 Typical High $63.10 | Professional | 56 · Pre-op care only | $34.67 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $363.08 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $239.88 | $363.08 | $436.52 |
Where Missouri sits
The same service costs 4.3 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
$813
WI $1,862TX $437
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.