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 $2,511.89 Median $5,754.40 Typical High $8,709.64 | Facility | None | $2,511.89 | $5,754.40 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $2,511.89 | Professional | None | $794.33 | $870.96 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $3,801.89 Typical High $7,244.36 | Facility | None | $1,380.38 | $3,801.89 | $7,244.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $724.44 Median $954.99 Typical High $1,318.26 | Professional | None | $724.44 | $954.99 | $1,318.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,071.52 Median $1,445.44 Typical High $1,949.84 | Professional | 50 · Both sides | $1,071.52 | $1,445.44 | $1,949.84 |
BCBS Kansas City Setting Professional Modifier None Typical Low $691.83 Median $954.99 Typical High $977.24 | Professional | None | $691.83 | $954.99 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $1,862.09 Typical High $7,585.78 | Facility | None | $1,122.02 | $1,862.09 | $7,585.78 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $741.31 Typical High $1,318.26 | Professional | None | $724.44 | $741.31 | $1,318.26 |
Medica Setting Facility Modifier None Typical Low $933.25 Median $2,754.23 Typical High $26,302.68 | Facility | None | $933.25 | $2,754.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $1,445.44 Typical High $5,623.41 | Professional | None | $645.65 | $1,445.44 | $5,623.41 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,623.41 | Facility | None | $1,000.00 | $2,818.38 | $5,623.41 |
United Setting Professional Modifier None Typical Low $645.65 Median $851.14 Typical High $1,479.11 | Professional | None | $645.65 | $851.14 | $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 $398.11 Median $436.52 Typical High $467.74 | Professional | 52 · Reduced service | $398.11 | $436.52 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $173.78 Typical High $186.21 | Professional | 53 · Discontinued | $158.49 | $173.78 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $645.65 Typical High $691.83 | Professional | 54 · Surgery only | $588.84 | $645.65 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $128.82 Typical High $138.04 | Professional | 55 · Aftercare only | $120.23 | $128.82 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $87.10 Typical High $93.33 | Professional | 56 · Pre-op care only | $79.43 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $602.56 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $549.54 | $602.56 | $645.65 |
Where Missouri sits
The same service costs 4.6 times more in Alaska than in New York. 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· 26th of 51
$1,096
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.