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 $660.69 Median $724.44 Typical High $977.24 | Professional | None | $660.69 | $724.44 | $977.24 |
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 $602.56 Median $758.58 Typical High $1,071.52 | Professional | None | $602.56 | $758.58 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $891.25 Median $1,148.15 Typical High $1,621.81 | Professional | 50 · Both sides | $891.25 | $1,148.15 | $1,621.81 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $380.19 Median $478.63 Typical High $676.08 | Professional | 62 · Two surgeons | $380.19 | $478.63 | $676.08 |
BCBS Kansas City Setting Professional Modifier None Typical Low $549.54 Median $588.84 Typical High $870.96 | Professional | None | $549.54 | $588.84 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,238.72 Typical High $3,311.31 | Facility | None | $758.58 | $2,238.72 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $645.65 Typical High $1,122.02 | Professional | None | $588.84 | $645.65 | $1,122.02 |
Medica Setting Facility Modifier None Typical Low $741.31 Median $3,715.35 Typical High $26,302.68 | Facility | None | $741.31 | $3,715.35 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $602.56 Median $1,148.15 Typical High $4,786.30 | Professional | None | $602.56 | $1,148.15 | $4,786.30 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,467.37 | $6,918.31 |
United Setting Professional Modifier None Typical Low $588.84 Median $741.31 Typical High $1,174.90 | Professional | None | $588.84 | $741.31 | $1,174.90 |
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 $331.13 Median $363.08 Typical High $389.05 | Professional | 52 · Reduced service | $331.13 | $363.08 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $144.54 Typical High $154.88 | Professional | 53 · Discontinued | $131.83 | $144.54 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $501.19 Median $537.03 Typical High $575.44 | Professional | 54 · Surgery only | $501.19 | $537.03 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $107.15 Typical High $117.49 | Professional | 55 · Aftercare only | $100.00 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $72.44 Typical High $77.62 | Professional | 56 · Pre-op care only | $66.07 | $72.44 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $467.74 Median $501.19 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $467.74 | $501.19 | $537.03 |
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· 29th of 51
$871
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.