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 $1,698.24 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $954.99 | Professional | None | $416.87 | $478.63 | $954.99 |
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 $436.52 Median $616.60 Typical High $831.76 | Professional | None | $436.52 | $616.60 | $831.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $660.69 Median $912.01 Typical High $1,258.93 | Professional | 50 · Both sides | $660.69 | $912.01 | $1,258.93 |
BCBS Kansas City Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $588.84 | Professional | None | $380.19 | $416.87 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,137.96 Typical High $2,691.53 | Facility | None | $645.65 | $2,137.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $933.25 | Professional | None | $407.38 | $457.09 | $933.25 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $2,754.23 Typical High $26,302.68 | Facility | None | $724.44 | $2,754.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $457.09 Median $1,047.13 Typical High $3,311.31 | Professional | None | $457.09 | $1,047.13 | $3,311.31 |
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 $426.58 Median $588.84 Typical High $1,148.15 | Professional | None | $426.58 | $588.84 | $1,148.15 |
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 $208.93 Median $234.42 Typical High $257.04 | Professional | 52 · Reduced service | $208.93 | $234.42 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $93.33 Typical High $102.33 | Professional | 53 · Discontinued | $83.18 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $354.81 Typical High $389.05 | Professional | 54 · Surgery only | $309.03 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $70.79 Typical High $77.62 | Professional | 55 · Aftercare only | $63.10 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $46.77 Typical High $51.29 | Professional | 56 · Pre-op care only | $41.69 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $331.13 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $288.40 | $331.13 | $363.08 |
Where Missouri sits
The same service costs 6.0 times more in Oklahoma 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· 23rd of 51
$646
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.