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 $1,548.82 Median $3,981.07 Typical High $7,762.47 | Facility | None | $1,548.82 | $3,981.07 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $1,548.82 | Professional | None | $389.05 | $489.78 | $1,548.82 |
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 $446.68 Median $575.44 Typical High $831.76 | Professional | None | $446.68 | $575.44 | $831.76 |
BCBS Kansas City Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $602.56 | Professional | None | $398.11 | $436.52 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,041.74 Typical High $2,511.89 | Facility | None | $602.56 | $2,041.74 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $478.63 Typical High $977.24 | Professional | None | $426.58 | $478.63 | $977.24 |
Medica Setting Facility Modifier None Typical Low $630.96 Median $3,715.35 Typical High $16,218.10 | Facility | None | $630.96 | $3,715.35 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $512.86 Median $954.99 Typical High $3,162.28 | Professional | None | $512.86 | $954.99 | $3,162.28 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,467.37 | $6,918.31 |
United Setting Professional Modifier None Typical Low $446.68 Median $645.65 Typical High $1,122.02 | Professional | None | $446.68 | $645.65 | $1,122.02 |
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 $194.98 Median $245.47 Typical High $251.19 | Professional | 52 · Reduced service | $194.98 | $245.47 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $97.72 Typical High $100.00 | Professional | 53 · Discontinued | $77.62 | $97.72 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $363.08 Typical High $380.19 | Professional | 54 · Surgery only | $295.12 | $363.08 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $72.44 Typical High $75.86 | Professional | 55 · Aftercare only | $58.88 | $72.44 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $48.98 Typical High $50.12 | Professional | 56 · Pre-op care only | $38.90 | $48.98 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $275.42 Median $338.84 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $275.42 | $338.84 | $354.81 |
Where Missouri sits
The same service costs 8.9 times more in Oklahoma 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· 29th of 51
$631
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.