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 $407.38 Median $5,248.07 Typical High $13,803.84 | Facility | None | $407.38 | $5,248.07 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $346.74 Typical High $407.38 | Professional | None | $199.53 | $346.74 | $407.38 |
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 $223.87 Median $281.84 Typical High $426.58 | Professional | None | $223.87 | $281.84 | $426.58 |
BCBS Kansas City Setting Professional Modifier None Typical Low $204.17 Median $363.08 Typical High $489.78 | Professional | None | $204.17 | $363.08 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $1,905.46 Typical High $5,248.07 | Facility | None | $1,202.26 | $1,905.46 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $338.84 Typical High $549.54 | Professional | None | $213.80 | $338.84 | $549.54 |
Medica Setting Facility Modifier None Typical Low $389.05 Median $2,344.23 Typical High $26,302.68 | Facility | None | $389.05 | $2,344.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $407.38 Median $1,621.81 Typical High $2,818.38 | Professional | None | $407.38 | $1,621.81 | $2,818.38 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $229.09 Median $380.19 Typical High $645.65 | Professional | None | $229.09 | $380.19 | $645.65 |
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 $100.00 Median $162.18 Typical High $204.17 | Professional | 52 · Reduced service | $100.00 | $162.18 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $39.81 Median $64.57 Typical High $81.28 | Professional | 53 · Discontinued | $39.81 | $64.57 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $245.47 Typical High $302.00 | Professional | 54 · Surgery only | $151.36 | $245.47 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $48.98 Typical High $60.26 | Professional | 55 · Aftercare only | $30.20 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $32.36 Typical High $40.74 | Professional | 56 · Pre-op care only | $19.95 | $32.36 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $229.09 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $141.25 | $229.09 | $281.84 |
Where Missouri sits
The same service costs 3.7 times more in Wyoming 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· 29th of 51
$347
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.