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 $1,548.82 Median $3,981.07 Typical High $7,762.47 | Facility | None | $1,548.82 | $3,981.07 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $371.54 Typical High $416.87 | Professional | None | $346.74 | $371.54 | $416.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $588.84 | Professional | None | $346.74 | $436.52 | $588.84 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $218.78 Median $275.42 Typical High $371.54 | Professional | 62 · Two surgeons | $218.78 | $275.42 | $371.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $371.54 Median $416.87 Typical High $575.44 | Professional | None | $371.54 | $416.87 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,778.28 Typical High $2,187.76 | Facility | None | $602.56 | $1,778.28 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $398.11 Typical High $724.44 | Professional | None | $354.81 | $398.11 | $724.44 |
Medica Setting Facility Modifier None Typical Low $691.83 Median $2,754.23 Typical High $16,218.10 | Facility | None | $691.83 | $2,754.23 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $436.52 Median $3,981.07 Typical High $3,981.07 | Professional | None | $436.52 | $3,981.07 | $3,981.07 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $346.74 Median $501.19 Typical High $912.01 | Professional | None | $346.74 | $501.19 | $912.01 |
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 $181.97 Typical High $208.93 | Professional | 52 · Reduced service | $173.78 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $72.44 Typical High $85.11 | Professional | 53 · Discontinued | $69.18 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $269.15 Typical High $316.23 | Professional | 54 · Surgery only | $257.04 | $269.15 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $53.70 Typical High $63.10 | Professional | 55 · Aftercare only | $52.48 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $36.31 Typical High $41.69 | Professional | 56 · Pre-op care only | $34.67 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $251.19 Typical High $295.12 | Professional | 78 · Unplanned return to OR | $239.88 | $251.19 | $295.12 |
Where Missouri sits
The same service costs 5.1 times more in Alaska than in Utah. 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· 32nd of 51
$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.