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 $302.00 Median $3,715.35 Typical High $6,309.57 | Facility | None | $302.00 | $3,715.35 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $269.15 Typical High $354.81 | Professional | None | $181.97 | $269.15 | $354.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $288.40 Typical High $478.63 | Professional | None | $213.80 | $288.40 | $478.63 |
BCBS Kansas City Setting Professional Modifier None Typical Low $194.98 Median $309.03 Typical High $407.38 | Professional | None | $194.98 | $309.03 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $426.58 Typical High $2,187.76 | Facility | None | $288.40 | $426.58 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $316.23 Typical High $630.96 | Professional | None | $194.98 | $316.23 | $630.96 |
Medica Setting Facility Modifier None Typical Low $151.36 Median $660.69 Typical High $16,218.10 | Facility | None | $151.36 | $660.69 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $380.19 Median $1,698.24 Typical High $2,187.76 | Professional | None | $380.19 | $1,698.24 | $2,187.76 |
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 $245.47 Median $407.38 Typical High $691.83 | Professional | None | $245.47 | $407.38 | $691.83 |
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 $91.20 Median $134.90 Typical High $154.88 | Professional | 52 · Reduced service | $91.20 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $53.70 Typical High $61.66 | Professional | 53 · Discontinued | $36.31 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $199.53 Typical High $234.42 | Professional | 54 · Surgery only | $134.90 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $39.81 Typical High $46.77 | Professional | 55 · Aftercare only | $27.54 | $39.81 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $26.92 Typical High $30.90 | Professional | 56 · Pre-op care only | $18.20 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $186.21 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $125.89 | $186.21 | $218.78 |
Where Missouri sits
The same service costs 3.7 times more in Wisconsin 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
$355
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.