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 $316.23 Median $3,162.28 Typical High $6,309.57 | Facility | None | $316.23 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $363.08 | Professional | None | $186.21 | $275.42 | $363.08 |
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 $245.47 Median $302.00 Typical High $537.03 | Professional | None | $245.47 | $302.00 | $537.03 |
BCBS Kansas City Setting Professional Modifier None Typical Low $199.53 Median $316.23 Typical High $436.52 | Professional | None | $199.53 | $316.23 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $398.11 Typical High $1,659.59 | Facility | None | $288.40 | $398.11 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $338.84 Typical High $660.69 | Professional | None | $194.98 | $338.84 | $660.69 |
Medica Setting Facility Modifier None Typical Low $151.36 Median $660.69 Typical High $12,022.64 | Facility | None | $151.36 | $660.69 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $426.58 Median $1,513.56 Typical High $2,187.76 | Professional | None | $426.58 | $1,513.56 | $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 $275.42 Median $457.09 Typical High $758.58 | Professional | None | $275.42 | $457.09 | $758.58 |
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 $93.33 Median $138.04 Typical High $158.49 | Professional | 52 · Reduced service | $93.33 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $54.95 Typical High $63.10 | Professional | 53 · Discontinued | $37.15 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $204.17 Typical High $239.88 | Professional | 54 · Surgery only | $138.04 | $204.17 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $40.74 Typical High $47.86 | Professional | 55 · Aftercare only | $27.54 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $27.54 Typical High $31.62 | Professional | 56 · Pre-op care only | $18.62 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $190.55 Typical High $223.87 | Professional | 78 · Unplanned return to OR | $128.82 | $190.55 | $223.87 |
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· 21st of 51
$380
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.