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 $1,412.54 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,412.54 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,905.46 | Professional | None | $776.25 | $977.24 | $1,905.46 |
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 $912.01 Median $1,230.27 Typical High $1,659.59 | Professional | None | $912.01 | $1,230.27 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $575.44 Median $758.58 Typical High $1,047.13 | Professional | 62 · Two surgeons | $575.44 | $758.58 | $1,047.13 |
BCBS Kansas City Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $1,174.90 | Professional | None | $776.25 | $851.14 | $1,174.90 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,691.53 Typical High $3,890.45 | Facility | None | $645.65 | $2,691.53 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $977.24 Typical High $1,905.46 | Professional | None | $851.14 | $977.24 | $1,905.46 |
Medica Setting Facility Modifier None Typical Low $1,071.52 Median $3,715.35 Typical High $26,302.68 | Facility | None | $1,071.52 | $3,715.35 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $1,023.29 Median $1,905.46 Typical High $7,762.47 | Professional | None | $1,023.29 | $1,905.46 | $7,762.47 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,467.37 | $6,918.31 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,230.27 Typical High $2,238.72 | Professional | None | $891.25 | $1,230.27 | $2,238.72 |
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 $380.19 Median $478.63 Typical High $489.78 | Professional | 52 · Reduced service | $380.19 | $478.63 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $190.55 Typical High $194.98 | Professional | 53 · Discontinued | $154.88 | $190.55 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $724.44 Typical High $741.31 | Professional | 54 · Surgery only | $575.44 | $724.44 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $144.54 Typical High $147.91 | Professional | 55 · Aftercare only | $114.82 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $95.50 Typical High $97.72 | Professional | 56 · Pre-op care only | $77.62 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $676.08 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $537.03 | $676.08 | $691.83 |
Where Missouri sits
The same service costs 5.9 times more in Alaska than in Texas. 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· 19th of 51
$1,445
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.