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 $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $1,479.11 | Professional | None | $588.84 | $588.84 | $1,479.11 |
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 $676.08 Median $933.25 Typical High $1,230.27 | Professional | None | $676.08 | $933.25 | $1,230.27 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,412.54 Typical High $1,862.09 | Professional | 50 · Both sides | $1,023.29 | $1,412.54 | $1,862.09 |
BCBS Kansas City Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $933.25 | Professional | None | $602.56 | $660.69 | $933.25 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $851.14 Typical High $2,691.53 | Facility | None | $588.84 | $851.14 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $1,513.56 | Professional | None | $616.60 | $758.58 | $1,513.56 |
Medica Setting Facility Modifier None Typical Low $616.60 Median $1,862.09 Typical High $26,302.68 | Facility | None | $616.60 | $1,862.09 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $691.83 Median $1,479.11 Typical High $5,011.87 | Professional | None | $691.83 | $1,479.11 | $5,011.87 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,235.94 | Facility | None | $562.34 | $1,513.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $691.83 Median $912.01 Typical High $1,513.56 | Professional | None | $691.83 | $912.01 | $1,513.56 |
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 $295.12 Median $295.12 Typical High $363.08 | Professional | 52 · Reduced service | $295.12 | $295.12 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $117.49 Typical High $144.54 | Professional | 53 · Discontinued | $117.49 | $117.49 | $144.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $446.68 Typical High $537.03 | Professional | 54 · Surgery only | $436.52 | $446.68 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $89.13 Typical High $107.15 | Professional | 55 · Aftercare only | $87.10 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $58.88 Typical High $72.44 | Professional | 56 · Pre-op care only | $58.88 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $416.87 Typical High $501.19 | Professional | 78 · Unplanned return to OR | $407.38 | $416.87 | $501.19 |
Where Missouri sits
The same service costs 5.9 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· 23rd of 51
$933
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.