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 $204.17 Median $3,162.28 Typical High $7,762.47 | Facility | None | $204.17 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $177.83 Typical High $223.87 | Professional | None | $141.25 | $177.83 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $204.17 Median $3,467.37 Typical High $7,079.46 | Facility | None | $204.17 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $331.13 | Professional | None | $162.18 | $213.80 | $331.13 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $102.33 Median $134.90 Typical High $208.93 | Professional | 62 · Two surgeons | $102.33 | $134.90 | $208.93 |
BCBS Kansas City Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $251.19 | Professional | None | $131.83 | $186.21 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $134.90 Typical High $1,659.59 | Facility | None | $89.13 | $134.90 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $194.98 Typical High $371.54 | Professional | None | $147.91 | $194.98 | $371.54 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $660.69 Typical High $2,344.23 | Facility | None | $54.95 | $660.69 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $1,047.13 Typical High $1,318.26 | Professional | None | $199.53 | $1,047.13 | $1,318.26 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $5,623.41 | Facility | None | $398.11 | $1,148.15 | $5,623.41 |
United Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $489.78 | Professional | None | $162.18 | $213.80 | $489.78 |
5 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 $70.79 Median $89.13 Typical High $112.20 | Professional | 52 · Reduced service | $70.79 | $89.13 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $35.48 Typical High $44.67 | Professional | 53 · Discontinued | $28.18 | $35.48 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $134.90 Typical High $165.96 | Professional | 54 · Surgery only | $107.15 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $26.92 Typical High $33.11 | Professional | 55 · Aftercare only | $21.38 | $26.92 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $17.78 Typical High $22.39 | Professional | 56 · Pre-op care only | $14.13 | $17.78 | $22.39 |
Where Missouri sits
The same service costs 3.4 times more in Alaska than in Pennsylvania. 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· 18th of 51
$240
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.