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 $138.04 Median $4,677.35 Typical High $7,762.47 | Facility | None | $138.04 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $154.88 | Professional | None | $95.50 | $138.04 | $154.88 |
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 $75.86 Median $112.20 Typical High $173.78 | Professional | None | $75.86 | $112.20 | $173.78 |
BCBS Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $208.93 | Professional | None | $100.00 | $151.36 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $112.20 Median $169.82 Typical High $1,659.59 | Facility | None | $112.20 | $169.82 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $302.00 | Professional | None | $100.00 | $151.36 | $302.00 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $812.83 Typical High $2,630.27 | Facility | None | $54.95 | $812.83 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $165.96 Median $776.25 Typical High $1,122.02 | Professional | None | $165.96 | $776.25 | $1,122.02 |
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 $112.20 Median $177.83 Typical High $302.00 | Professional | None | $112.20 | $177.83 | $302.00 |
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 $47.86 Median $69.18 Typical High $77.62 | Professional | 52 · Reduced service | $47.86 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $27.54 Typical High $30.90 | Professional | 53 · Discontinued | $19.05 | $27.54 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $104.71 Typical High $114.82 | Professional | 54 · Surgery only | $70.79 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $20.89 Typical High $23.44 | Professional | 55 · Aftercare only | $14.13 | $20.89 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $13.80 Typical High $15.49 | Professional | 56 · Pre-op care only | $9.55 | $13.80 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $97.72 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $66.07 | $97.72 | $107.15 |
Where Missouri sits
The same service costs 4.4 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· 36th of 51
$158
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.