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 $354.81 Median $4,677.35 Typical High $7,762.47 | Facility | None | $354.81 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $316.23 Typical High $371.54 | Professional | None | $204.17 | $316.23 | $371.54 |
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 $204.17 Median $239.88 Typical High $354.81 | Professional | None | $204.17 | $239.88 | $354.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $302.00 Median $354.81 Typical High $524.81 | Professional | 50 · Both sides | $302.00 | $354.81 | $524.81 |
BCBS Kansas City Setting Professional Modifier None Typical Low $181.97 Median $295.12 Typical High $338.84 | Professional | None | $181.97 | $295.12 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $354.81 Typical High $2,691.53 | Facility | None | $234.42 | $354.81 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $295.12 Typical High $478.63 | Professional | None | $194.98 | $295.12 | $478.63 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,412.54 Typical High $3,467.37 | Facility | None | $54.95 | $1,412.54 | $3,467.37 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $1,479.11 Typical High $3,235.94 | Professional | None | $302.00 | $1,479.11 | $3,235.94 |
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 $218.78 Median $309.03 Typical High $512.86 | Professional | None | $218.78 | $309.03 | $512.86 |
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 $102.33 Median $151.36 Typical High $186.21 | Professional | 52 · Reduced service | $102.33 | $151.36 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $60.26 Typical High $74.13 | Professional | 53 · Discontinued | $40.74 | $60.26 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $223.87 Typical High $275.42 | Professional | 54 · Surgery only | $154.88 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $44.67 Typical High $54.95 | Professional | 55 · Aftercare only | $30.90 | $44.67 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $30.20 Typical High $37.15 | Professional | 56 · Pre-op care only | $20.42 | $30.20 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $208.93 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $144.54 | $208.93 | $257.04 |
Where Missouri sits
The same service costs 4.2 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· 31st of 51
$331
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.