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 $645.65 Median $691.83 Typical High $758.58 | Professional | None | $645.65 | $691.83 | $758.58 |
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 $524.81 Median $660.69 Typical High $1,000.00 | Professional | None | $524.81 | $660.69 | $1,000.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $794.33 Median $977.24 Typical High $1,513.56 | Professional | 50 · Both sides | $794.33 | $977.24 | $1,513.56 |
BCBS Kansas City Setting Professional Modifier None Typical Low $537.03 Median $562.34 Typical High $851.14 | Professional | None | $537.03 | $562.34 | $851.14 |
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 $575.44 Median $630.96 Typical High $1,047.13 | Professional | None | $575.44 | $630.96 | $1,047.13 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $1,348.96 Typical High $26,302.68 | Facility | None | $446.68 | $1,348.96 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $575.44 Median $1,122.02 Typical High $5,495.41 | Professional | None | $575.44 | $1,122.02 | $5,495.41 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $2,398.83 | Facility | None | $398.11 | $1,148.15 | $2,398.83 |
United Setting Professional Modifier None Typical Low $575.44 Median $707.95 Typical High $1,148.15 | Professional | None | $575.44 | $707.95 | $1,148.15 |
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 $323.59 Median $346.74 Typical High $380.19 | Professional | 52 · Reduced service | $323.59 | $346.74 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $138.04 Typical High $151.36 | Professional | 53 · Discontinued | $128.82 | $138.04 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $524.81 Typical High $562.34 | Professional | 54 · Surgery only | $478.63 | $524.81 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $95.50 Median $104.71 Typical High $112.20 | Professional | 55 · Aftercare only | $95.50 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $69.18 Typical High $75.86 | Professional | 56 · Pre-op care only | $64.57 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $489.78 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $446.68 | $489.78 | $524.81 |
Where Missouri sits
The same service costs 7.6 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· 33rd of 51
$741
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.