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 $10.47 Median $10.47 Typical High $13.18 | Facility | None | $10.47 | $10.47 | $13.18 |
Aetna Setting Professional Modifier None Typical Low $10.47 Median $10.96 Typical High $12.02 | Professional | None | $10.47 | $10.96 | $12.02 |
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 $12.02 Median $15.85 Typical High $25.70 | Professional | None | $12.02 | $15.85 | $25.70 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $17.78 Median $22.91 Typical High $38.02 | Professional | 50 · Both sides | $17.78 | $22.91 | $38.02 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $7.76 Median $10.00 Typical High $16.60 | Professional | 62 · Two surgeons | $7.76 | $10.00 | $16.60 |
BCBS Kansas City Setting Professional Modifier None Typical Low $10.72 Median $11.75 Typical High $16.22 | Professional | None | $10.72 | $11.75 | $16.22 |
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 $11.48 Median $15.49 Typical High $28.18 | Professional | None | $11.48 | $15.49 | $28.18 |
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 $11.22 Median $28.18 Typical High $660.69 | Professional | None | $11.22 | $28.18 | $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 $11.22 Median $14.13 Typical High $27.54 | Professional | None | $11.22 | $14.13 | $27.54 |
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 $5.25 Median $5.50 Typical High $6.03 | Professional | 52 · Reduced service | $5.25 | $5.50 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.09 Median $2.19 Typical High $2.40 | Professional | 53 · Discontinued | $2.09 | $2.19 | $2.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.58 Median $1.66 Typical High $1.82 | Professional | 55 · Aftercare only | $1.58 | $1.66 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.05 Median $1.12 Typical High $1.20 | Professional | 56 · Pre-op care only | $1.05 | $1.12 | $1.20 |
Where Missouri sits
The same service costs 12.3 times more in Florida 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· 27th of 51
$19.50
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.