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 $275.42 Median $3,162.28 Typical High $7,762.47 | Facility | None | $275.42 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $239.88 Typical High $295.12 | Professional | None | $151.36 | $239.88 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $234.42 Typical High $398.11 | Professional | None | $102.33 | $234.42 | $398.11 |
BCBS Kansas City Setting Professional Modifier None Typical Low $154.88 Median $251.19 Typical High $338.84 | Professional | None | $154.88 | $251.19 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $302.00 Typical High $1,659.59 | Facility | None | $199.53 | $302.00 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $269.15 Typical High $524.81 | Professional | None | $162.18 | $269.15 | $524.81 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,023.29 Typical High $2,630.27 | Facility | None | $54.95 | $1,023.29 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $1,230.27 Typical High $1,905.46 | Professional | None | $323.59 | $1,230.27 | $1,905.46 |
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 $204.17 Median $331.13 Typical High $602.56 | Professional | None | $204.17 | $331.13 | $602.56 |
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 $75.86 Median $117.49 Typical High $138.04 | Professional | 52 · Reduced service | $75.86 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $46.77 Typical High $54.95 | Professional | 53 · Discontinued | $30.20 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $173.78 Typical High $208.93 | Professional | 54 · Surgery only | $114.82 | $173.78 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $35.48 Typical High $41.69 | Professional | 55 · Aftercare only | $22.91 | $35.48 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $23.44 Typical High $27.54 | Professional | 56 · Pre-op care only | $15.14 | $23.44 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $162.18 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $107.15 | $162.18 | $194.98 |
Where Missouri sits
The same service costs 4.3 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· 27th of 51
$295
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.