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 $660.69 Median $5,623.41 Typical High $10,715.19 | Facility | None | $660.69 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $660.69 | Professional | None | $446.68 | $562.34 | $660.69 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,288.25 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $741.31 | Professional | None | $426.58 | $562.34 | $741.31 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $645.65 Median $851.14 Typical High $1,122.02 | Professional | 50 · Both sides | $645.65 | $851.14 | $1,122.02 |
BCBS Kansas City Setting Professional Modifier None Typical Low $389.05 Median $549.54 Typical High $630.96 | Professional | None | $389.05 | $549.54 | $630.96 |
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 $407.38 Median $524.81 Typical High $851.14 | Professional | None | $407.38 | $524.81 | $851.14 |
Medica Setting Facility Modifier None Typical Low $630.96 Median $2,754.23 Typical High $26,302.68 | Facility | None | $630.96 | $2,754.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $501.19 Median $3,630.78 Typical High $4,677.35 | Professional | None | $501.19 | $3,630.78 | $4,677.35 |
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 $407.38 Median $537.03 Typical High $912.01 | Professional | None | $407.38 | $537.03 | $912.01 |
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 $223.87 Median $269.15 Typical High $331.13 | Professional | 52 · Reduced service | $223.87 | $269.15 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $109.65 Typical High $131.83 | Professional | 53 · Discontinued | $89.13 | $109.65 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $338.84 Median $407.38 Typical High $489.78 | Professional | 54 · Surgery only | $338.84 | $407.38 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $81.28 Typical High $100.00 | Professional | 55 · Aftercare only | $67.61 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $54.95 Typical High $66.07 | Professional | 56 · Pre-op care only | $44.67 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $316.23 Median $380.19 Typical High $457.09 | Professional | 78 · Unplanned return to OR | $316.23 | $380.19 | $457.09 |
Where Missouri sits
The same service costs 6.5 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· 28th of 51
$646
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.