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 $363.08 Median $3,162.28 Typical High $6,309.57 | Facility | None | $363.08 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $346.74 Typical High $457.09 | Professional | None | $316.23 | $346.74 | $457.09 |
Ambetter Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $436.52 | Professional | None | $234.42 | $302.00 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $436.52 Median $1,621.81 Typical High $6,165.95 | Facility | None | $436.52 | $1,621.81 | $6,165.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $524.81 | Professional | None | $269.15 | $323.59 | $524.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $407.38 Median $489.78 Typical High $776.25 | Professional | 50 · Both sides | $407.38 | $489.78 | $776.25 |
BCBS Kansas City Setting Professional Modifier None Typical Low $281.84 Median $331.13 Typical High $426.58 | Professional | None | $281.84 | $331.13 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $436.52 Typical High $2,187.76 | Facility | None | $295.12 | $436.52 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $323.59 Typical High $562.34 | Professional | None | $281.84 | $323.59 | $562.34 |
Medica Setting Facility Modifier None Typical Low $371.54 Median $1,096.48 Typical High $16,218.10 | Facility | None | $371.54 | $1,096.48 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $2,344.23 Typical High $2,511.89 | Professional | None | $302.00 | $2,344.23 | $2,511.89 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $2,818.38 | Facility | None | $398.11 | $1,148.15 | $2,818.38 |
United Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $575.44 | Professional | None | $281.84 | $354.81 | $575.44 |
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 $158.49 Median $173.78 Typical High $199.53 | Professional | 52 · Reduced service | $158.49 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $69.18 Typical High $79.43 | Professional | 53 · Discontinued | $64.57 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $257.04 Typical High $302.00 | Professional | 54 · Surgery only | $229.09 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $51.29 Typical High $60.26 | Professional | 55 · Aftercare only | $47.86 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $34.67 Typical High $39.81 | Professional | 56 · Pre-op care only | $31.62 | $34.67 | $39.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $239.88 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $223.87 | $239.88 | $281.84 |
Where Missouri sits
The same service costs 5.8 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· 30th of 51
$372
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.