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 $812.83 Median $812.83 Typical High $2,511.89 | Professional | None | $812.83 | $812.83 | $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 $891.25 Median $1,288.25 Typical High $1,698.24 | Professional | None | $891.25 | $1,288.25 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,348.96 Median $1,905.46 Typical High $2,570.40 | Professional | 50 · Both sides | $1,348.96 | $1,905.46 | $2,570.40 |
BCBS Kansas City Setting Professional Modifier None Typical Low $831.76 Median $912.01 Typical High $1,258.93 | Professional | None | $831.76 | $912.01 | $1,258.93 |
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 $851.14 Median $1,023.29 Typical High $2,041.74 | Professional | None | $851.14 | $1,023.29 | $2,041.74 |
Medica Setting Facility Modifier None Typical Low $1,174.90 Median $4,365.16 Typical High $26,302.68 | Facility | None | $1,174.90 | $4,365.16 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $933.25 Median $2,041.74 Typical High $7,079.46 | Professional | None | $933.25 | $2,041.74 | $7,079.46 |
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 $912.01 Median $1,230.27 Typical High $2,041.74 | Professional | None | $912.01 | $1,230.27 | $2,041.74 |
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 $398.11 Median $407.38 Typical High $501.19 | Professional | 52 · Reduced service | $398.11 | $407.38 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $162.18 Median $162.18 Typical High $199.53 | Professional | 53 · Discontinued | $162.18 | $162.18 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $616.60 Typical High $741.31 | Professional | 54 · Surgery only | $602.56 | $616.60 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $123.03 Typical High $147.91 | Professional | 55 · Aftercare only | $120.23 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $100.00 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $562.34 Median $575.44 Typical High $691.83 | Professional | 78 · Unplanned return to OR | $562.34 | $575.44 | $691.83 |
Where Missouri sits
The same service costs 7.2 times more in Alaska than in Texas. 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
$1,380
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.