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 $2,454.71 Median $5,623.41 Typical High $13,803.84 | Facility | None | $2,454.71 | $5,623.41 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,122.02 Median $1,148.15 Typical High $2,511.89 | Professional | None | $1,122.02 | $1,148.15 | $2,511.89 |
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 $1,258.93 Median $1,737.80 Typical High $2,398.83 | Professional | None | $1,258.93 | $1,737.80 | $2,398.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,862.09 Median $2,570.40 Typical High $3,548.13 | Professional | 50 · Both sides | $1,862.09 | $2,570.40 | $3,548.13 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,174.90 Median $1,288.25 Typical High $1,819.70 | Professional | None | $1,174.90 | $1,288.25 | $1,819.70 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $5,248.07 | Facility | None | $1,202.26 | $3,801.89 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,412.54 Typical High $2,884.03 | Professional | None | $1,174.90 | $1,412.54 | $2,884.03 |
Medica Setting Facility Modifier None Typical Low $1,380.38 Median $4,365.16 Typical High $26,302.68 | Facility | None | $1,380.38 | $4,365.16 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $1,288.25 Median $2,754.23 Typical High $9,549.93 | Professional | None | $1,288.25 | $2,754.23 | $9,549.93 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,981.07 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,698.24 Typical High $2,818.38 | Professional | None | $1,258.93 | $1,698.24 | $2,818.38 |
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 $562.34 Median $575.44 Typical High $691.83 | Professional | 52 · Reduced service | $562.34 | $575.44 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $229.09 Typical High $275.42 | Professional | 53 · Discontinued | $223.87 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $851.14 Typical High $1,047.13 | Professional | 54 · Surgery only | $851.14 | $851.14 | $1,047.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $169.82 Median $169.82 Typical High $208.93 | Professional | 55 · Aftercare only | $169.82 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $112.20 Median $114.82 Typical High $138.04 | Professional | 56 · Pre-op care only | $112.20 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $794.33 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $794.33 | $794.33 | $977.24 |
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· 32nd of 51
$1,738
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.