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 $1,148.15 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,148.15 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $467.74 | Professional | None | $380.19 | $416.87 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $1,621.81 Typical High $3,981.07 | Facility | None | $151.36 | $1,621.81 | $3,981.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $363.08 Median $446.68 Typical High $630.96 | Professional | None | $363.08 | $446.68 | $630.96 |
BCBS Kansas City Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $575.44 | Professional | None | $363.08 | $407.38 | $575.44 |
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 $389.05 Median $426.58 Typical High $794.33 | Professional | None | $389.05 | $426.58 | $794.33 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $478.63 Typical High $2,951.21 | Facility | None | $54.95 | $478.63 | $2,951.21 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $3,090.30 Typical High $3,090.30 | Professional | None | $489.78 | $3,090.30 | $3,090.30 |
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 $380.19 Median $562.34 Typical High $977.24 | Professional | None | $380.19 | $562.34 | $977.24 |
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 $190.55 Median $199.53 Typical High $234.42 | Professional | 52 · Reduced service | $190.55 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $81.28 Typical High $93.33 | Professional | 53 · Discontinued | $75.86 | $81.28 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $302.00 Typical High $346.74 | Professional | 54 · Surgery only | $288.40 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $60.26 Typical High $69.18 | Professional | 55 · Aftercare only | $57.54 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $39.81 Typical High $46.77 | Professional | 56 · Pre-op care only | $38.02 | $39.81 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $281.84 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $269.15 | $281.84 | $323.59 |
Where Missouri sits
The same service costs 4.2 times more in Wyoming than in Utah. 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· 30th of 51
$468
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.