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 $5,623.41 Typical High $10,715.19 | Facility | None | $1,698.24 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $691.83 | Professional | None | $588.84 | $630.96 | $691.83 |
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 $512.86 Median $645.65 Typical High $933.25 | Professional | None | $512.86 | $645.65 | $933.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $977.24 Typical High $1,412.54 | Professional | 50 · Both sides | $776.25 | $977.24 | $1,412.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $489.78 Median $524.81 Typical High $707.95 | Professional | None | $489.78 | $524.81 | $707.95 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $1,412.54 Typical High $3,311.31 | Facility | None | $758.58 | $1,412.54 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $977.24 | Professional | None | $524.81 | $562.34 | $977.24 |
Medica Setting Facility Modifier None Typical Low $776.25 Median $2,754.23 Typical High $26,302.68 | Facility | None | $776.25 | $2,754.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $1,000.00 Typical High $4,265.80 | Professional | None | $478.63 | $1,000.00 | $4,265.80 |
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 $478.63 Median $630.96 Typical High $1,047.13 | Professional | None | $478.63 | $630.96 | $1,047.13 |
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 $295.12 Median $316.23 Typical High $346.74 | Professional | 52 · Reduced service | $295.12 | $316.23 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $128.82 Typical High $138.04 | Professional | 53 · Discontinued | $117.49 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $478.63 Typical High $512.86 | Professional | 54 · Surgery only | $446.68 | $478.63 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $95.50 Typical High $104.71 | Professional | 55 · Aftercare only | $89.13 | $95.50 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $63.10 Typical High $69.18 | Professional | 56 · Pre-op care only | $58.88 | $63.10 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $446.68 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $416.87 | $446.68 | $478.63 |
Where Missouri sits
The same service costs 8.5 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
$692
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.