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 $1,148.15 Median $3,715.35 Typical High $7,762.47 | Facility | None | $1,148.15 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,023.29 Typical High $1,621.81 | Professional | None | $891.25 | $1,023.29 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,801.89 Typical High $11,481.54 | Facility | None | $1,318.26 | $3,801.89 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $933.25 Median $1,230.27 Typical High $1,778.28 | Professional | None | $933.25 | $1,230.27 | $1,778.28 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $588.84 Median $776.25 Typical High $1,174.90 | Professional | 62 · Two surgeons | $588.84 | $776.25 | $1,174.90 |
BCBS Kansas City Setting Professional Modifier None Typical Low $794.33 Median $891.25 Typical High $1,230.27 | Professional | None | $794.33 | $891.25 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,691.53 Typical High $4,073.80 | Facility | None | $707.95 | $2,691.53 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,000.00 Typical High $1,995.26 | Professional | None | $870.96 | $1,000.00 | $1,995.26 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,905.46 Typical High $14,454.40 | Facility | None | $54.95 | $1,905.46 | $14,454.40 |
Medica Setting Professional Modifier None Typical Low $977.24 Median $2,238.72 Typical High $6,456.54 | Professional | None | $977.24 | $2,238.72 | $6,456.54 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $17,378.01 | Facility | None | $1,000.00 | $2,818.38 | $17,378.01 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,258.93 Typical High $2,454.71 | Professional | None | $912.01 | $1,258.93 | $2,454.71 |
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 $446.68 Median $501.19 Typical High $549.54 | Professional | 52 · Reduced service | $446.68 | $501.19 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $199.53 Typical High $218.78 | Professional | 53 · Discontinued | $177.83 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $758.58 Typical High $812.83 | Professional | 54 · Surgery only | $660.69 | $758.58 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $151.36 Typical High $162.18 | Professional | 55 · Aftercare only | $131.83 | $151.36 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $100.00 Typical High $109.65 | Professional | 56 · Pre-op care only | $89.13 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $707.95 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $616.60 | $707.95 | $758.58 |
Where Missouri sits
The same service costs 5.8 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· 26th of 51
$1,259
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.