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 $2,511.89 Median $5,623.41 Typical High $14,125.38 | Facility | None | $2,511.89 | $5,623.41 | $14,125.38 |
Aetna Setting Professional Modifier None Typical Low $1,148.15 Median $1,318.26 Typical High $4,365.16 | Professional | None | $1,148.15 | $1,318.26 | $4,365.16 |
Ambetter Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,288.25 | Professional | None | $1,288.25 | $1,288.25 | $1,288.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,912.51 Median $10,000.00 Typical High $16,218.10 | Facility | None | $8,912.51 | $10,000.00 | $16,218.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $2,187.76 | Professional | None | $1,230.27 | $1,513.56 | $2,187.76 |
BCBS Kansas City Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $1,412.54 | Professional | None | $977.24 | $1,047.13 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $7,413.10 Median $18,620.87 Typical High $28,183.83 | Facility | None | $7,413.10 | $18,620.87 | $28,183.83 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,445.44 Typical High $2,398.83 | Professional | None | $1,047.13 | $1,445.44 | $2,398.83 |
Medica Setting Facility Modifier None Typical Low $1,174.90 Median $4,265.80 Typical High $16,595.87 | Facility | None | $1,174.90 | $4,265.80 | $16,595.87 |
Medica Setting Professional Modifier None Typical Low $1,412.54 Median $2,630.27 Typical High $8,709.64 | Professional | None | $1,412.54 | $2,630.27 | $8,709.64 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,570.88 Typical High $18,197.01 | Facility | None | $977.24 | $4,570.88 | $18,197.01 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $1,949.84 Typical High $2,884.03 | Professional | None | $1,148.15 | $1,949.84 | $2,884.03 |
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 $575.44 Median $602.56 Typical High $660.69 | Professional | 52 · Reduced service | $575.44 | $602.56 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $229.09 Median $239.88 Typical High $263.03 | Professional | 53 · Discontinued | $229.09 | $239.88 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $851.14 Median $912.01 Typical High $1,000.00 | Professional | 54 · Surgery only | $851.14 | $912.01 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $181.97 Typical High $199.53 | Professional | 55 · Aftercare only | $173.78 | $181.97 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $114.82 Median $120.23 Typical High $131.83 | Professional | 56 · Pre-op care only | $114.82 | $120.23 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $794.33 Median $851.14 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $794.33 | $851.14 | $933.25 |
Where Missouri sits
The same service costs 8.9 times more in Oklahoma than in Texas. 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· 23rd of 51
$1,778
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.