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 $263.03 Median $3,162.28 Typical High $7,762.47 | Facility | None | $263.03 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $245.47 Typical High $288.40 | Professional | None | $120.23 | $245.47 | $288.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $1,621.81 Typical High $3,890.45 | Facility | None | $151.36 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $134.90 Typical High $208.93 | Professional | None | $112.20 | $134.90 | $208.93 |
BCBS Kansas City Setting Professional Modifier None Typical Low $114.82 Median $239.88 Typical High $346.74 | Professional | None | $114.82 | $239.88 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $134.90 Typical High $190.55 | Facility | None | $58.88 | $134.90 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $239.88 Typical High $478.63 | Professional | None | $120.23 | $239.88 | $478.63 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $331.13 Typical High $1,513.56 | Facility | None | $54.95 | $331.13 | $1,513.56 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $1,000.00 Typical High $1,949.84 | Professional | None | $263.03 | $1,000.00 | $1,949.84 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,137.96 | Facility | None | $123.03 | $602.56 | $2,137.96 |
United Setting Professional Modifier None Typical Low $134.90 Median $257.04 Typical High $478.63 | Professional | None | $134.90 | $257.04 | $478.63 |
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 $56.23 Median $123.03 Typical High $131.83 | Professional | 52 · Reduced service | $56.23 | $123.03 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $48.98 Typical High $52.48 | Professional | 53 · Discontinued | $22.39 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $181.97 Typical High $199.53 | Professional | 54 · Surgery only | $83.18 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $36.31 Typical High $39.81 | Professional | 55 · Aftercare only | $16.60 | $36.31 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $24.55 Typical High $26.30 | Professional | 56 · Pre-op care only | $11.22 | $24.55 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $169.82 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $77.62 | $169.82 | $186.21 |
Where Missouri sits
The same service costs 3.6 times more in Wisconsin 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· 30th of 51
$224
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.