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 $354.81 Median $426.58 Typical High $1,548.82 | Professional | None | $354.81 | $426.58 | $1,548.82 |
Ambetter Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $10,000.00 | Facility | None | $1,412.54 | $3,801.89 | $10,000.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $602.56 Typical High $741.31 | Professional | None | $467.74 | $602.56 | $741.31 |
BCBS Setting Professional Modifier None Typical Low $416.87 Median $467.74 Typical High $645.65 | Professional | None | $416.87 | $467.74 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,691.53 | Facility | None | $489.78 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $1,000.00 | Professional | None | $446.68 | $512.86 | $1,000.00 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,174.90 Typical High $6,918.31 | Facility | None | $54.95 | $1,174.90 | $6,918.31 |
Medica Setting Professional Modifier None Typical Low $426.58 Median $831.76 Typical High $3,388.44 | Professional | None | $426.58 | $831.76 | $3,388.44 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,290.87 Typical High $10,964.78 | Facility | None | $467.74 | $2,290.87 | $10,964.78 |
United Setting Professional Modifier None Typical Low $398.11 Median $537.03 Typical High $870.96 | Professional | None | $398.11 | $537.03 | $870.96 |
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 $177.83 Median $213.80 Typical High $218.78 | Professional | 52 · Reduced service | $177.83 | $213.80 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $85.11 Typical High $87.10 | Professional | 53 · Discontinued | $70.79 | $85.11 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $316.23 Typical High $331.13 | Professional | 54 · Surgery only | $269.15 | $316.23 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $64.57 Typical High $66.07 | Professional | 55 · Aftercare only | $53.70 | $64.57 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $42.66 Typical High $43.65 | Professional | 56 · Pre-op care only | $35.48 | $42.66 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $295.12 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $251.19 | $295.12 | $309.03 |
Where Missouri sits
The same service costs 7.4 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
$617
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.