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 $524.81 Median $3,162.28 Typical High $7,762.47 | Facility | None | $524.81 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $524.81 | Professional | None | $346.74 | $446.68 | $524.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,258.93 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $295.12 Median $354.81 Typical High $562.34 | Professional | None | $295.12 | $354.81 | $562.34 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $446.68 Median $537.03 Typical High $851.14 | Professional | 50 · Both sides | $446.68 | $537.03 | $851.14 |
BCBS Kansas City Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $489.78 | Professional | None | $302.00 | $436.52 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $436.52 Typical High $2,691.53 | Facility | None | $295.12 | $436.52 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $398.11 Typical High $676.08 | Professional | None | $316.23 | $398.11 | $676.08 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,659.59 Typical High $3,467.37 | Facility | None | $54.95 | $1,659.59 | $3,467.37 |
Medica Setting Professional Modifier None Typical Low $371.54 Median $2,570.40 Typical High $3,235.94 | Professional | None | $371.54 | $2,570.40 | $3,235.94 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $309.03 Median $407.38 Typical High $724.44 | Professional | None | $309.03 | $407.38 | $724.44 |
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 $173.78 Median $213.80 Typical High $263.03 | Professional | 52 · Reduced service | $173.78 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $85.11 Typical High $104.71 | Professional | 53 · Discontinued | $69.18 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $323.59 Typical High $389.05 | Professional | 54 · Surgery only | $263.03 | $323.59 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $64.57 Typical High $79.43 | Professional | 55 · Aftercare only | $52.48 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $42.66 Typical High $52.48 | Professional | 56 · Pre-op care only | $34.67 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $302.00 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $245.47 | $302.00 | $363.08 |
Where Missouri sits
The same service costs 5.0 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· 33rd of 51
$447
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.