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 $41.69 Median $41.69 Typical High $51.29 | Facility | None | $41.69 | $41.69 | $51.29 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $44.67 Typical High $47.86 | Professional | None | $41.69 | $44.67 | $47.86 |
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 $47.86 Median $60.26 Typical High $97.72 | Professional | None | $47.86 | $60.26 | $97.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $72.44 Median $91.20 Typical High $147.91 | Professional | 50 · Both sides | $72.44 | $91.20 | $147.91 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $30.20 Median $38.02 Typical High $61.66 | Professional | 62 · Two surgeons | $30.20 | $38.02 | $61.66 |
BCBS Kansas City Setting Professional Modifier None Typical Low $41.69 Median $45.71 Typical High $63.10 | Professional | None | $41.69 | $45.71 | $63.10 |
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 $45.71 Median $61.66 Typical High $109.65 | Professional | None | $45.71 | $61.66 | $109.65 |
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 $44.67 Median $107.15 Typical High $660.69 | Professional | None | $44.67 | $107.15 | $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 $44.67 Median $54.95 Typical High $112.20 | Professional | None | $44.67 | $54.95 | $112.20 |
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 $20.89 Median $22.39 Typical High $23.99 | Professional | 52 · Reduced service | $20.89 | $22.39 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.91 Typical High $9.55 | Professional | 53 · Discontinued | $8.51 | $8.91 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.61 Typical High $7.24 | Professional | 55 · Aftercare only | $6.31 | $6.61 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.47 Typical High $4.79 | Professional | 56 · Pre-op care only | $4.17 | $4.47 | $4.79 |
Where Missouri sits
The same service costs 4.7 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· 23rd of 51
$75.86
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.