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 $933.25 Median $1,174.90 Typical High $1,659.59 | Professional | None | $933.25 | $1,174.90 | $1,659.59 |
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 $1,023.29 Median $1,230.27 Typical High $1,862.09 | Professional | None | $1,023.29 | $1,230.27 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $645.65 Median $776.25 Typical High $1,148.15 | Professional | 62 · Two surgeons | $645.65 | $776.25 | $1,148.15 |
BCBS Kansas City Setting Professional Modifier None Typical Low $933.25 Median $1,023.29 Typical High $1,412.54 | Professional | None | $933.25 | $1,023.29 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,288.25 Typical High $2,691.53 | Facility | None | $707.95 | $1,288.25 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $2,290.87 | Professional | None | $1,023.29 | $1,148.15 | $2,290.87 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,905.46 Typical High $9,549.93 | Facility | None | $54.95 | $1,905.46 | $9,549.93 |
Medica Setting Professional Modifier None Typical Low $1,230.27 Median $2,290.87 Typical High $7,585.78 | Professional | None | $1,230.27 | $2,290.87 | $7,585.78 |
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 $1,071.52 Median $1,548.82 Typical High $2,691.53 | Professional | None | $1,071.52 | $1,548.82 | $2,691.53 |
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 $467.74 Median $575.44 Typical High $588.84 | Professional | 52 · Reduced service | $467.74 | $575.44 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $234.42 Typical High $239.88 | Professional | 53 · Discontinued | $186.21 | $234.42 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $870.96 Typical High $891.25 | Professional | 54 · Surgery only | $691.83 | $870.96 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $173.78 Typical High $177.83 | Professional | 55 · Aftercare only | $138.04 | $173.78 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $117.49 Typical High $120.23 | Professional | 56 · Pre-op care only | $93.33 | $117.49 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $812.83 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $645.65 | $812.83 | $831.76 |
Where Missouri sits
The same service costs 5.9 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· 25th of 51
$1,413
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.