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 $2,089.30 Median $5,623.41 Typical High $8,709.64 | Facility | None | $2,089.30 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $2,511.89 | Professional | None | $575.44 | $645.65 | $2,511.89 |
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 $524.81 Median $724.44 Typical High $1,096.48 | Professional | None | $524.81 | $724.44 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $1,071.52 Typical High $1,659.59 | Professional | 50 · Both sides | $794.33 | $1,071.52 | $1,659.59 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $331.13 Median $457.09 Typical High $691.83 | Professional | 62 · Two surgeons | $331.13 | $457.09 | $691.83 |
BCBS Kansas City Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $831.76 | Professional | None | $537.03 | $588.84 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $2,238.72 Typical High $3,801.89 | Facility | None | $912.01 | $2,238.72 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $630.96 Typical High $1,288.25 | Professional | None | $549.54 | $630.96 | $1,288.25 |
Medica Setting Facility Modifier None Typical Low $741.31 Median $3,715.35 Typical High $26,302.68 | Facility | None | $741.31 | $3,715.35 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $602.56 Median $1,445.44 Typical High $4,073.80 | Professional | None | $602.56 | $1,445.44 | $4,073.80 |
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 $549.54 Median $758.58 Typical High $1,584.89 | Professional | None | $549.54 | $758.58 | $1,584.89 |
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 $281.84 Median $323.59 Typical High $354.81 | Professional | 52 · Reduced service | $281.84 | $323.59 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $128.82 Typical High $141.25 | Professional | 53 · Discontinued | $114.82 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $478.63 Typical High $524.81 | Professional | 54 · Surgery only | $426.58 | $478.63 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $95.50 Typical High $104.71 | Professional | 55 · Aftercare only | $85.11 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $64.57 Typical High $70.79 | Professional | 56 · Pre-op care only | $57.54 | $64.57 | $70.79 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $446.68 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $398.11 | $446.68 | $489.78 |
Where Missouri sits
The same service costs 8.7 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· 25th of 51
$813
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.