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 $4,677.35 Typical High $9,549.93 | Facility | None | $1,548.82 | $4,677.35 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $1,548.82 | Professional | None | $512.86 | $549.54 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $3,801.89 Typical High $9,549.93 | Facility | None | $1,380.38 | $3,801.89 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $831.76 | Professional | None | $457.09 | $588.84 | $831.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $891.25 Typical High $1,230.27 | Professional | 50 · Both sides | $691.83 | $891.25 | $1,230.27 |
BCBS Kansas City Setting Professional Modifier None Typical Low $426.58 Median $457.09 Typical High $660.69 | Professional | None | $426.58 | $457.09 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,398.83 Typical High $12,302.69 | Facility | None | $707.95 | $2,398.83 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $851.14 | Professional | None | $457.09 | $501.19 | $851.14 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $2,754.23 Typical High $16,218.10 | Facility | None | $724.44 | $2,754.23 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $446.68 Median $891.25 Typical High $3,715.35 | Professional | None | $446.68 | $891.25 | $3,715.35 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $6,456.54 | Facility | None | $1,000.00 | $2,818.38 | $6,456.54 |
United Setting Professional Modifier None Typical Low $446.68 Median $562.34 Typical High $912.01 | Professional | None | $446.68 | $562.34 | $912.01 |
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 $257.04 Median $275.42 Typical High $302.00 | Professional | 52 · Reduced service | $257.04 | $275.42 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $109.65 Typical High $120.23 | Professional | 53 · Discontinued | $102.33 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $416.87 Typical High $446.68 | Professional | 54 · Surgery only | $380.19 | $416.87 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $83.18 Typical High $89.13 | Professional | 55 · Aftercare only | $75.86 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $54.95 Typical High $60.26 | Professional | 56 · Pre-op care only | $51.29 | $54.95 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $389.05 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $354.81 | $389.05 | $416.87 |
Where Missouri sits
The same service costs 7.9 times more in Wyoming 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· 29th of 51
$661
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.