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 $676.08 Median $4,677.35 Typical High $7,762.47 | Facility | None | $676.08 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $691.83 | Professional | None | $416.87 | $562.34 | $691.83 |
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 $512.86 Median $660.69 Typical High $1,096.48 | Professional | None | $512.86 | $660.69 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $758.58 Median $977.24 Typical High $1,659.59 | Professional | 50 · Both sides | $758.58 | $977.24 | $1,659.59 |
BCBS Kansas City Setting Professional Modifier None Typical Low $446.68 Median $660.69 Typical High $870.96 | Professional | None | $446.68 | $660.69 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,905.46 Typical High $2,691.53 | Facility | None | $645.65 | $1,905.46 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $645.65 Typical High $1,288.25 | Professional | None | $457.09 | $645.65 | $1,288.25 |
Medica Setting Facility Modifier None Typical Low $776.25 Median $2,754.23 Typical High $26,302.68 | Facility | None | $776.25 | $2,754.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $707.95 Median $4,466.84 Typical High $4,897.79 | Professional | None | $707.95 | $4,466.84 | $4,897.79 |
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 $501.19 Median $724.44 Typical High $1,258.93 | Professional | None | $501.19 | $724.44 | $1,258.93 |
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 $208.93 Median $281.84 Typical High $331.13 | Professional | 52 · Reduced service | $208.93 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $112.20 Typical High $134.90 | Professional | 53 · Discontinued | $83.18 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $426.58 Typical High $501.19 | Professional | 54 · Surgery only | $309.03 | $426.58 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $85.11 Typical High $100.00 | Professional | 55 · Aftercare only | $61.66 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $56.23 Typical High $67.61 | Professional | 56 · Pre-op care only | $41.69 | $56.23 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $398.11 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $288.40 | $398.11 | $467.74 |
Where Missouri sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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· 35th of 51
$724
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.