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 $70.79 Median $70.79 Typical High $85.11 | Facility | None | $70.79 | $70.79 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $74.13 Typical High $81.28 | Professional | None | $70.79 | $74.13 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $100.00 Typical High $162.18 | Professional | None | $81.28 | $100.00 | $162.18 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $123.03 Median $147.91 Typical High $245.47 | Professional | 50 · Both sides | $123.03 | $147.91 | $245.47 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $51.29 Median $63.10 Typical High $102.33 | Professional | 62 · Two surgeons | $51.29 | $63.10 | $102.33 |
BCBS Kansas City Setting Professional Modifier None Typical Low $69.18 Median $75.86 Typical High $107.15 | Professional | None | $69.18 | $75.86 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $1,412.54 Typical High $1,659.59 | Facility | None | $426.58 | $1,412.54 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $100.00 Typical High $181.97 | Professional | None | $77.62 | $100.00 | $181.97 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $251.19 Typical High $1,288.25 | Facility | None | $54.95 | $251.19 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $75.86 Median $181.97 Typical High $660.69 | Professional | None | $75.86 | $181.97 | $660.69 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,137.96 | Facility | None | $123.03 | $602.56 | $2,137.96 |
United Setting Professional Modifier None Typical Low $74.13 Median $91.20 Typical High $186.21 | Professional | None | $74.13 | $91.20 | $186.21 |
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 52 · Reduced service Typical Low $35.48 Median $37.15 Typical High $40.74 | Professional | 52 · Reduced service | $35.48 | $37.15 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $14.79 Typical High $16.22 | Professional | 53 · Discontinued | $14.13 | $14.79 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $11.22 Typical High $12.02 | Professional | 55 · Aftercare only | $10.72 | $11.22 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.41 Typical High $8.13 | Professional | 56 · Pre-op care only | $7.08 | $7.41 | $8.13 |
Where Missouri sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 24th of 51
$123
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.