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 $446.68 Median $3,715.35 Typical High $7,762.47 | Facility | None | $446.68 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $380.19 Typical High $446.68 | Professional | None | $239.88 | $380.19 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,288.25 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $398.11 | Professional | None | $234.42 | $275.42 | $398.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $346.74 Median $407.38 Typical High $602.56 | Professional | 50 · Both sides | $346.74 | $407.38 | $602.56 |
BCBS Kansas City Setting Professional Modifier None Typical Low $204.17 Median $363.08 Typical High $407.38 | Professional | None | $204.17 | $363.08 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $363.08 Typical High $3,801.89 | Facility | None | $239.88 | $363.08 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $549.54 | Professional | None | $229.09 | $354.81 | $549.54 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,659.59 Typical High $3,467.37 | Facility | None | $54.95 | $1,659.59 | $3,467.37 |
Medica Setting Professional Modifier None Typical Low $346.74 Median $1,737.80 Typical High $3,548.13 | Professional | None | $346.74 | $1,737.80 | $3,548.13 |
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 $223.87 Median $363.08 Typical High $602.56 | Professional | None | $223.87 | $363.08 | $602.56 |
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 $120.23 Median $181.97 Typical High $223.87 | Professional | 52 · Reduced service | $120.23 | $181.97 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $72.44 Typical High $89.13 | Professional | 53 · Discontinued | $48.98 | $72.44 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $269.15 Typical High $331.13 | Professional | 54 · Surgery only | $181.97 | $269.15 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $53.70 Typical High $66.07 | Professional | 55 · Aftercare only | $36.31 | $53.70 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $36.31 Typical High $44.67 | Professional | 56 · Pre-op care only | $23.99 | $36.31 | $44.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $251.19 Typical High $309.03 | Professional | 78 · Unplanned return to OR | $169.82 | $251.19 | $309.03 |
Where Missouri sits
The same service costs 3.9 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· 28th of 51
$380
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.