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 $1,348.96 Median $1,621.81 Typical High $2,041.74 | Professional | None | $1,348.96 | $1,621.81 | $2,041.74 |
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 $1,548.82 Median $2,187.76 Typical High $2,884.03 | Professional | None | $1,548.82 | $2,187.76 | $2,884.03 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $977.24 Median $1,380.38 Typical High $1,819.70 | Professional | 62 · Two surgeons | $977.24 | $1,380.38 | $1,819.70 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,584.89 Median $1,778.28 Typical High $2,454.71 | Professional | None | $1,584.89 | $1,778.28 | $2,454.71 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $2,818.38 Typical High $6,760.83 | Facility | None | $1,621.81 | $2,818.38 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $1,621.81 Median $1,905.46 Typical High $3,630.78 | Professional | None | $1,621.81 | $1,905.46 | $3,630.78 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,951.21 Typical High $22,387.21 | Facility | None | $54.95 | $2,951.21 | $22,387.21 |
Medica Setting Professional Modifier None Typical Low $1,949.84 Median $3,715.35 Typical High $12,589.25 | Professional | None | $1,949.84 | $3,715.35 | $12,589.25 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $17,378.01 | Facility | None | $1,258.93 | $3,981.07 | $17,378.01 |
United Setting Professional Modifier None Typical Low $1,778.28 Median $2,454.71 Typical High $4,365.16 | Professional | None | $1,778.28 | $2,454.71 | $4,365.16 |
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 $676.08 Median $812.83 Typical High $831.76 | Professional | 52 · Reduced service | $676.08 | $812.83 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $331.13 Typical High $338.84 | Professional | 53 · Discontinued | $275.42 | $331.13 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $1,230.27 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,023.29 | $1,230.27 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $204.17 Median $245.47 Typical High $251.19 | Professional | 55 · Aftercare only | $204.17 | $245.47 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $134.90 Median $162.18 Typical High $169.82 | Professional | 56 · Pre-op care only | $134.90 | $162.18 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $1,148.15 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $954.99 | $1,148.15 | $1,174.90 |
Where Missouri sits
The same service costs 6.6 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· 22nd of 51
$2,455
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.