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 $257.04 Median $3,715.35 Typical High $6,309.57 | Facility | None | $257.04 | $3,715.35 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $234.42 Typical High $288.40 | Professional | None | $151.36 | $234.42 | $288.40 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $1,621.81 Typical High $3,890.45 | Facility | None | $151.36 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $257.04 | Professional | None | $144.54 | $169.82 | $257.04 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $213.80 Median $251.19 Typical High $389.05 | Professional | 50 · Both sides | $213.80 | $251.19 | $389.05 |
BCBS Kansas City Setting Professional Modifier None Typical Low $131.83 Median $229.09 Typical High $263.03 | Professional | None | $131.83 | $229.09 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $257.04 Typical High $1,659.59 | Facility | None | $173.78 | $257.04 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $229.09 Typical High $338.84 | Professional | None | $144.54 | $229.09 | $338.84 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,318.26 Typical High $3,890.45 | Facility | None | $54.95 | $1,318.26 | $3,890.45 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $1,096.48 Typical High $2,344.23 | Professional | None | $218.78 | $1,096.48 | $2,344.23 |
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 $138.04 Median $223.87 Typical High $380.19 | Professional | None | $138.04 | $223.87 | $380.19 |
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 $75.86 Median $114.82 Typical High $141.25 | Professional | 52 · Reduced service | $75.86 | $114.82 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $45.71 Typical High $56.23 | Professional | 53 · Discontinued | $30.20 | $45.71 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $169.82 Typical High $213.80 | Professional | 54 · Surgery only | $114.82 | $169.82 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $33.88 Typical High $42.66 | Professional | 55 · Aftercare only | $22.91 | $33.88 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $22.91 Typical High $28.18 | Professional | 56 · Pre-op care only | $15.14 | $22.91 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $158.49 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $107.15 | $158.49 | $199.53 |
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
$240
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.