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 $128.82 Median $3,715.35 Typical High $6,309.57 | Facility | None | $128.82 | $3,715.35 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $165.96 | Professional | None | $87.10 | $128.82 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $1,621.81 Typical High $3,890.45 | Facility | None | $151.36 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $123.03 Median $151.36 Typical High $263.03 | Professional | None | $123.03 | $151.36 | $263.03 |
BCBS Kansas City Setting Professional Modifier None Typical Low $107.15 Median $158.49 Typical High $218.78 | Professional | None | $107.15 | $158.49 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $134.90 Typical High $2,691.53 | Facility | None | $89.13 | $134.90 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $162.18 Typical High $288.40 | Professional | None | $112.20 | $162.18 | $288.40 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,318.26 Typical High $3,890.45 | Facility | None | $54.95 | $1,318.26 | $3,890.45 |
Medica Setting Professional Modifier None Typical Low $154.88 Median $831.76 Typical High $1,258.93 | Professional | None | $154.88 | $831.76 | $1,258.93 |
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 $123.03 Median $165.96 Typical High $316.23 | Professional | None | $123.03 | $165.96 | $316.23 |
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 $42.66 Median $64.57 Typical High $79.43 | Professional | 52 · Reduced service | $42.66 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $25.70 Typical High $32.36 | Professional | 53 · Discontinued | $17.38 | $25.70 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $95.50 Typical High $120.23 | Professional | 54 · Surgery only | $64.57 | $95.50 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $19.50 Typical High $23.99 | Professional | 55 · Aftercare only | $12.88 | $19.50 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $12.88 Typical High $16.22 | Professional | 56 · Pre-op care only | $8.71 | $12.88 | $16.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $60.26 Median $89.13 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $60.26 | $89.13 | $112.20 |
Where Missouri sits
The same service costs 3.6 times more in Wisconsin than in Texas. 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· 34th of 51
$170
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.