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 $173.78 Median $4,677.35 Typical High $7,762.47 | Facility | None | $173.78 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $173.78 Typical High $208.93 | Professional | None | $104.71 | $173.78 | $208.93 |
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 $102.33 Median $181.97 Typical High $295.12 | Professional | None | $102.33 | $181.97 | $295.12 |
BCBS Kansas City Setting Professional Modifier None Typical Low $117.49 Median $204.17 Typical High $281.84 | Professional | None | $117.49 | $204.17 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $66.07 | Facility | None | $50.12 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $194.98 Typical High $389.05 | Professional | None | $112.20 | $194.98 | $389.05 |
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 $245.47 Median $851.14 Typical High $1,412.54 | Professional | None | $245.47 | $851.14 | $1,412.54 |
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 $147.91 Median $251.19 Typical High $446.68 | Professional | None | $147.91 | $251.19 | $446.68 |
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 $52.48 Median $87.10 Typical High $102.33 | Professional | 52 · Reduced service | $52.48 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $34.67 Typical High $40.74 | Professional | 53 · Discontinued | $20.89 | $34.67 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $128.82 Typical High $151.36 | Professional | 54 · Surgery only | $77.62 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $25.70 Typical High $30.20 | Professional | 55 · Aftercare only | $15.49 | $25.70 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $17.38 Typical High $20.42 | Professional | 56 · Pre-op care only | $10.47 | $17.38 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $120.23 Typical High $141.25 | Professional | 78 · Unplanned return to OR | $72.44 | $120.23 | $141.25 |
Where Missouri sits
The same service costs 3.8 times more in Wisconsin than in Hawaii. 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· 27th of 51
$214
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.