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 $954.99 Median $1,023.29 Typical High $1,412.54 | Professional | None | $954.99 | $1,023.29 | $1,412.54 |
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 $691.83 Median $851.14 Typical High $1,380.38 | Professional | None | $691.83 | $851.14 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,047.13 Median $1,288.25 Typical High $2,089.30 | Professional | 50 · Both sides | $1,047.13 | $1,288.25 | $2,089.30 |
BCBS Kansas City Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $1,148.15 | Professional | None | $812.83 | $870.96 | $1,148.15 |
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 $831.76 Median $891.25 Typical High $1,584.89 | Professional | None | $831.76 | $891.25 | $1,584.89 |
Medica Setting Facility Modifier None Typical Low $912.01 Median $3,801.89 Typical High $26,302.68 | Facility | None | $912.01 | $3,801.89 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $724.44 Median $1,513.56 Typical High $6,918.31 | Professional | None | $724.44 | $1,513.56 | $6,918.31 |
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 $724.44 Median $933.25 Typical High $1,621.81 | Professional | None | $724.44 | $933.25 | $1,621.81 |
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 $478.63 Median $512.86 Typical High $562.34 | Professional | 52 · Reduced service | $478.63 | $512.86 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $204.17 Typical High $223.87 | Professional | 53 · Discontinued | $190.55 | $204.17 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $758.58 Typical High $851.14 | Professional | 54 · Surgery only | $724.44 | $758.58 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $154.88 Typical High $169.82 | Professional | 55 · Aftercare only | $144.54 | $154.88 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $102.33 Typical High $112.20 | Professional | 56 · Pre-op care only | $95.50 | $102.33 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $707.95 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $676.08 | $707.95 | $794.33 |
Where Missouri sits
The same service costs 8.1 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
$1,047
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.