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 $575.44 Median $5,623.41 Typical High $10,715.19 | Facility | None | $575.44 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $933.25 | Professional | None | $457.09 | $524.81 | $933.25 |
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 $467.74 Median $660.69 Typical High $912.01 | Professional | None | $467.74 | $660.69 | $912.01 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $1,000.00 Typical High $1,348.96 | Professional | 50 · Both sides | $707.95 | $1,000.00 | $1,348.96 |
BCBS Kansas City Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $645.65 | Professional | None | $426.58 | $467.74 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,187.76 Typical High $3,311.31 | Facility | None | $758.58 | $2,187.76 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $1,023.29 | Professional | None | $446.68 | $512.86 | $1,023.29 |
Medica Setting Facility Modifier None Typical Low $776.25 Median $2,754.23 Typical High $26,302.68 | Facility | None | $776.25 | $2,754.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $501.19 Median $1,174.90 Typical High $3,801.89 | Professional | None | $501.19 | $1,174.90 | $3,801.89 |
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 $467.74 Median $660.69 Typical High $1,258.93 | Professional | None | $467.74 | $660.69 | $1,258.93 |
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 $229.09 Median $263.03 Typical High $281.84 | Professional | 52 · Reduced service | $229.09 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $104.71 Typical High $114.82 | Professional | 53 · Discontinued | $91.20 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $346.74 Median $389.05 Typical High $426.58 | Professional | 54 · Surgery only | $346.74 | $389.05 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $77.62 Typical High $85.11 | Professional | 55 · Aftercare only | $69.18 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $52.48 Typical High $57.54 | Professional | 56 · Pre-op care only | $45.71 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $323.59 Median $363.08 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $323.59 | $363.08 | $398.11 |
Where Missouri sits
The same service costs 8.7 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· 25th of 51
$692
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.