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 $208.93 Median $4,677.35 Typical High $7,762.47 | Facility | None | $208.93 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $208.93 Typical High $251.19 | Professional | None | $134.90 | $208.93 | $251.19 |
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 $138.04 Median $223.87 Typical High $398.11 | Professional | None | $138.04 | $223.87 | $398.11 |
BCBS Kansas City Setting Professional Modifier None Typical Low $141.25 Median $234.42 Typical High $323.59 | Professional | None | $141.25 | $234.42 | $323.59 |
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 $141.25 Median $245.47 Typical High $501.19 | Professional | None | $141.25 | $245.47 | $501.19 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $331.13 Typical High $1,288.25 | Facility | None | $54.95 | $331.13 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $1,096.48 Typical High $1,659.59 | Professional | None | $331.13 | $1,096.48 | $1,659.59 |
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 $199.53 Median $331.13 Typical High $602.56 | Professional | None | $199.53 | $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 $67.61 Median $104.71 Typical High $120.23 | Professional | 52 · Reduced service | $67.61 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $41.69 Typical High $48.98 | Professional | 53 · Discontinued | $26.92 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $154.88 Typical High $181.97 | Professional | 54 · Surgery only | $100.00 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $30.90 Typical High $36.31 | Professional | 55 · Aftercare only | $19.95 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $20.89 Typical High $23.99 | Professional | 56 · Pre-op care only | $13.49 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $144.54 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $93.33 | $144.54 | $169.82 |
Where Missouri sits
The same service costs 3.7 times more in Wisconsin than in Texas. 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
$269
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.