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 $138.04 Median $173.78 Typical High $407.38 | Professional | None | $138.04 | $173.78 | $407.38 |
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 $169.82 Median $229.09 Typical High $331.13 | Professional | None | $169.82 | $229.09 | $331.13 |
BCBS Kansas City Setting Professional Modifier None Typical Low $158.49 Median $177.83 Typical High $245.47 | Professional | None | $158.49 | $177.83 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,584.89 Typical High $2,691.53 | Facility | None | $707.95 | $1,584.89 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $416.87 | Professional | None | $169.82 | $223.87 | $416.87 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,071.52 Typical High $6,760.83 | Facility | None | $54.95 | $1,071.52 | $6,760.83 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $446.68 Typical High $1,348.96 | Professional | None | $177.83 | $446.68 | $1,348.96 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,235.94 | Facility | None | $562.34 | $1,513.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $173.78 Median $245.47 Typical High $467.74 | Professional | None | $173.78 | $245.47 | $467.74 |
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 $69.18 Median $87.10 Typical High $89.13 | Professional | 52 · Reduced service | $69.18 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $34.67 Typical High $35.48 | Professional | 53 · Discontinued | $28.18 | $34.67 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $128.82 Typical High $134.90 | Professional | 54 · Surgery only | $104.71 | $128.82 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $25.70 Typical High $26.92 | Professional | 55 · Aftercare only | $20.89 | $25.70 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $17.38 Typical High $17.78 | Professional | 56 · Pre-op care only | $13.80 | $17.38 | $17.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $120.23 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $97.72 | $120.23 | $125.89 |
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· 30th of 51
$257
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.