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 $245.47 Median $3,715.35 Typical High $7,762.47 | Facility | None | $245.47 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $218.78 Typical High $371.54 | Professional | None | $169.82 | $218.78 | $371.54 |
Ambetter Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
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 $199.53 Median $234.42 Typical High $380.19 | Professional | None | $199.53 | $234.42 | $380.19 |
BCBS Kansas City Setting Professional Modifier None Typical Low $177.83 Median $223.87 Typical High $309.03 | Professional | None | $177.83 | $223.87 | $309.03 |
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 $190.55 Median $251.19 Typical High $467.74 | Professional | None | $190.55 | $251.19 | $467.74 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $2,344.23 Typical High $16,218.10 | Facility | None | $295.12 | $2,344.23 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $1,380.38 Typical High $2,238.72 | Professional | None | $269.15 | $1,380.38 | $2,238.72 |
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 $213.80 Median $302.00 Typical High $489.78 | Professional | None | $213.80 | $302.00 | $489.78 |
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 $85.11 Median $109.65 Typical High $125.89 | Professional | 52 · Reduced service | $85.11 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $43.65 Typical High $50.12 | Professional | 53 · Discontinued | $33.88 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $165.96 Typical High $186.21 | Professional | 54 · Surgery only | $125.89 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $33.11 Typical High $37.15 | Professional | 55 · Aftercare only | $25.70 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $21.88 Typical High $25.12 | Professional | 56 · Pre-op care only | $16.98 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $154.88 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $117.49 | $154.88 | $173.78 |
Where Missouri sits
The same service costs 5.9 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
$288
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.