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 $630.96 Median $3,162.28 Typical High $7,762.47 | Facility | None | $630.96 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $588.84 Typical High $794.33 | Professional | None | $512.86 | $588.84 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $933.25 Typical High $1,380.38 | Professional | None | $524.81 | $933.25 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $1,412.54 Typical High $2,041.74 | Professional | 50 · Both sides | $776.25 | $1,412.54 | $2,041.74 |
BCBS Kansas City Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $691.83 | Professional | None | $436.52 | $524.81 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $416.87 Typical High $1,659.59 | Facility | None | $295.12 | $416.87 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $1,023.29 | Professional | None | $457.09 | $512.86 | $1,023.29 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,096.48 Typical High $3,548.13 | Facility | None | $54.95 | $1,096.48 | $3,548.13 |
Medica Setting Professional Modifier None Typical Low $549.54 Median $3,890.45 Typical High $5,495.41 | Professional | None | $549.54 | $3,890.45 | $5,495.41 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $2,238.72 | Facility | None | $398.11 | $1,148.15 | $2,238.72 |
United Setting Professional Modifier None Typical Low $489.78 Median $602.56 Typical High $1,023.29 | Professional | None | $489.78 | $602.56 | $1,023.29 |
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 $257.04 Median $275.42 Typical High $316.23 | Professional | 52 · Reduced service | $257.04 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $109.65 Typical High $125.89 | Professional | 53 · Discontinued | $102.33 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $416.87 Typical High $478.63 | Professional | 54 · Surgery only | $380.19 | $416.87 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $83.18 Typical High $95.50 | Professional | 55 · Aftercare only | $75.86 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $54.95 Typical High $63.10 | Professional | 56 · Pre-op care only | $51.29 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $389.05 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $354.81 | $389.05 | $446.68 |
Where Missouri sits
The same service costs 6.2 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· 21st of 51
$794
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.