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 $1,148.15 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,148.15 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $1,174.90 | Professional | None | $275.42 | $338.84 | $1,174.90 |
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 $302.00 Median $354.81 Typical High $602.56 | Professional | None | $302.00 | $354.81 | $602.56 |
BCBS Kansas City Setting Professional Modifier None Typical Low $316.23 Median $346.74 Typical High $489.78 | Professional | None | $316.23 | $346.74 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,698.24 Typical High $2,511.89 | Facility | None | $446.68 | $1,698.24 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $389.05 Typical High $812.83 | Professional | None | $323.59 | $389.05 | $812.83 |
Medica Setting Facility Modifier None Typical Low $645.65 Median $2,754.23 Typical High $12,022.64 | Facility | None | $645.65 | $2,754.23 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $851.14 Typical High $2,691.53 | Professional | None | $331.13 | $851.14 | $2,691.53 |
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 $331.13 Median $467.74 Typical High $933.25 | Professional | None | $331.13 | $467.74 | $933.25 |
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 $138.04 Median $169.82 Typical High $173.78 | Professional | 52 · Reduced service | $138.04 | $169.82 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $67.61 Typical High $69.18 | Professional | 53 · Discontinued | $54.95 | $67.61 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $257.04 Typical High $263.03 | Professional | 54 · Surgery only | $204.17 | $257.04 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $51.29 Typical High $52.48 | Professional | 55 · Aftercare only | $41.69 | $51.29 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $33.88 Typical High $34.67 | Professional | 56 · Pre-op care only | $27.54 | $33.88 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $239.88 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $190.55 | $239.88 | $245.47 |
Where Missouri sits
The same service costs 8.5 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· 32nd of 51
$457
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.