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 $891.25 Median $933.25 Typical High $1,288.25 | Professional | None | $891.25 | $933.25 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,288.25 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $707.95 Median $851.14 Typical High $1,258.93 | Professional | None | $707.95 | $851.14 | $1,258.93 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,288.25 Typical High $1,862.09 | Professional | 50 · Both sides | $1,047.13 | $1,288.25 | $1,862.09 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $446.68 Median $537.03 Typical High $794.33 | Professional | 62 · Two surgeons | $446.68 | $537.03 | $794.33 |
BCBS Kansas City Setting Professional Modifier None Typical Low $758.58 Median $794.33 Typical High $1,047.13 | Professional | None | $758.58 | $794.33 | $1,047.13 |
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 $741.31 Median $831.76 Typical High $1,445.44 | Professional | None | $741.31 | $831.76 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $851.14 Median $3,801.89 Typical High $26,302.68 | Facility | None | $851.14 | $3,801.89 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $676.08 Median $1,380.38 Typical High $6,309.57 | Professional | None | $676.08 | $1,380.38 | $6,309.57 |
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 $676.08 Median $831.76 Typical High $1,479.11 | Professional | None | $676.08 | $831.76 | $1,479.11 |
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 $467.74 Typical High $512.86 | Professional | 52 · Reduced service | $446.68 | $467.74 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $186.21 Typical High $208.93 | Professional | 53 · Discontinued | $177.83 | $186.21 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $707.95 Typical High $776.25 | Professional | 54 · Surgery only | $660.69 | $707.95 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $131.83 Median $141.25 Typical High $154.88 | Professional | 55 · Aftercare only | $131.83 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $93.33 Typical High $104.71 | Professional | 56 · Pre-op care only | $89.13 | $93.33 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $660.69 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $616.60 | $660.69 | $724.44 |
Where Missouri sits
The same service costs 8.3 times more in Wyoming 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· 32nd of 51
$977
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.