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 $2,511.89 Median $6,309.57 Typical High $14,791.08 | Facility | None | $2,511.89 | $6,309.57 | $14,791.08 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $2,511.89 | Professional | None | $758.58 | $870.96 | $2,511.89 |
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 $831.76 Median $1,047.13 Typical High $1,548.82 | Professional | None | $831.76 | $1,047.13 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,584.89 Typical High $2,290.87 | Professional | 50 · Both sides | $1,258.93 | $1,584.89 | $2,290.87 |
BCBS Kansas City Setting Professional Modifier None Typical Low $691.83 Median $758.58 Typical High $1,071.52 | Professional | None | $691.83 | $758.58 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $3,715.35 Typical High $4,466.84 | Facility | None | $912.01 | $3,715.35 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $912.01 Typical High $1,737.80 | Professional | None | $741.31 | $912.01 | $1,737.80 |
Medica Setting Facility Modifier None Typical Low $1,023.29 Median $5,011.87 Typical High $16,218.10 | Facility | None | $1,023.29 | $5,011.87 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $1,949.84 Typical High $5,623.41 | Professional | None | $851.14 | $1,949.84 | $5,623.41 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,570.88 Typical High $13,489.63 | Facility | None | $977.24 | $4,570.88 | $13,489.63 |
United Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $2,089.30 | Professional | None | $794.33 | $1,096.48 | $2,089.30 |
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 $380.19 Median $436.52 Typical High $467.74 | Professional | 52 · Reduced service | $380.19 | $436.52 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $173.78 Typical High $190.55 | Professional | 53 · Discontinued | $154.88 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $575.44 Median $645.65 Typical High $707.95 | Professional | 54 · Surgery only | $575.44 | $645.65 | $707.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $128.82 Typical High $141.25 | Professional | 55 · Aftercare only | $114.82 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $87.10 Typical High $95.50 | Professional | 56 · Pre-op care only | $75.86 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $537.03 Median $602.56 Typical High $660.69 | Professional | 78 · Unplanned return to OR | $537.03 | $602.56 | $660.69 |
Where Missouri sits
The same service costs 7.2 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· 28th of 51
$1,096
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.