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 $1,148.15 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,148.15 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $1,621.81 | Professional | None | $741.31 | $741.31 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,548.13 Typical High $7,762.47 | Facility | None | $1,288.25 | $3,548.13 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $831.76 Median $1,071.52 Typical High $1,548.82 | Professional | None | $831.76 | $1,071.52 | $1,548.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,258.93 Median $1,584.89 Typical High $2,344.23 | Professional | 50 · Both sides | $1,258.93 | $1,584.89 | $2,344.23 |
BCBS Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,148.15 | Professional | None | $758.58 | $831.76 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,659.59 Typical High $2,137.96 | Facility | None | $446.68 | $1,659.59 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $977.24 Typical High $1,905.46 | Professional | None | $776.25 | $977.24 | $1,905.46 |
Medica Setting Facility Modifier None Typical Low $1,047.13 Median $4,365.16 Typical High $12,022.64 | Facility | None | $1,047.13 | $4,365.16 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $870.96 Median $1,862.09 Typical High $6,309.57 | Professional | None | $870.96 | $1,862.09 | $6,309.57 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $8,912.51 | Facility | None | $1,258.93 | $3,981.07 | $8,912.51 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,148.15 Typical High $1,905.46 | Professional | None | $851.14 | $1,148.15 | $1,905.46 |
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 $371.54 Median $371.54 Typical High $457.09 | Professional | 52 · Reduced service | $371.54 | $371.54 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $147.91 Median $147.91 Typical High $181.97 | Professional | 53 · Discontinued | $147.91 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $562.34 Typical High $676.08 | Professional | 54 · Surgery only | $549.54 | $562.34 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $112.20 Typical High $134.90 | Professional | 55 · Aftercare only | $109.65 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $74.13 Median $74.13 Typical High $91.20 | Professional | 56 · Pre-op care only | $74.13 | $74.13 | $91.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $524.81 Typical High $630.96 | Professional | 78 · Unplanned return to OR | $512.86 | $524.81 | $630.96 |
Where Missouri sits
The same service costs 6.9 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
$1,175
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.