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 $64.57 Median $64.57 Typical High $77.62 | Facility | None | $64.57 | $64.57 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $67.61 Typical High $74.13 | Professional | None | $64.57 | $67.61 | $74.13 |
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 $72.44 Median $91.20 Typical High $154.88 | Professional | None | $72.44 | $91.20 | $154.88 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $109.65 Median $134.90 Typical High $234.42 | Professional | 50 · Both sides | $109.65 | $134.90 | $234.42 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $45.71 Median $57.54 Typical High $97.72 | Professional | 62 · Two surgeons | $45.71 | $57.54 | $97.72 |
BCBS Kansas City Setting Professional Modifier None Typical Low $63.10 Median $69.18 Typical High $95.50 | Professional | None | $63.10 | $69.18 | $95.50 |
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 $69.18 Median $91.20 Typical High $165.96 | Professional | None | $69.18 | $91.20 | $165.96 |
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 $67.61 Median $162.18 Typical High $660.69 | Professional | None | $67.61 | $162.18 | $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 $67.61 Median $83.18 Typical High $169.82 | Professional | None | $67.61 | $83.18 | $169.82 |
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 $32.36 Median $33.88 Typical High $37.15 | Professional | 52 · Reduced service | $32.36 | $33.88 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $13.49 Typical High $14.79 | Professional | 53 · Discontinued | $12.88 | $13.49 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $10.23 Typical High $10.96 | Professional | 55 · Aftercare only | $9.55 | $10.23 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.76 Typical High $7.41 | Professional | 56 · Pre-op care only | $6.46 | $6.76 | $7.41 |
Where Missouri sits
The same service costs 4.5 times more in Wisconsin 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· 20th of 51
$112
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.