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 $251.19 Median $3,235.94 Typical High $6,309.57 | Facility | None | $251.19 | $3,235.94 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $245.47 Typical High $446.68 | Professional | None | $173.78 | $245.47 | $446.68 |
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 $223.87 Median $316.23 Typical High $478.63 | Professional | None | $223.87 | $316.23 | $478.63 |
BCBS Kansas City Setting Professional Modifier None Typical Low $208.93 Median $331.13 Typical High $371.54 | Professional | None | $208.93 | $331.13 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $954.99 Typical High $2,187.76 | Facility | None | $602.56 | $954.99 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $537.03 | Professional | None | $223.87 | $338.84 | $537.03 |
Medica Setting Facility Modifier None Typical Low $407.38 Median $1,584.89 Typical High $16,218.10 | Facility | None | $407.38 | $1,584.89 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $1,778.28 Typical High $2,511.89 | Professional | None | $309.03 | $1,778.28 | $2,511.89 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,235.94 | Facility | None | $562.34 | $1,513.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $213.80 Median $323.59 Typical High $562.34 | Professional | None | $213.80 | $323.59 | $562.34 |
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 $87.10 Median $123.03 Typical High $147.91 | Professional | 52 · Reduced service | $87.10 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $48.98 Typical High $60.26 | Professional | 53 · Discontinued | $34.67 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $186.21 Typical High $223.87 | Professional | 54 · Surgery only | $128.82 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $37.15 Typical High $44.67 | Professional | 55 · Aftercare only | $26.30 | $37.15 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $24.55 Typical High $30.20 | Professional | 56 · Pre-op care only | $17.38 | $24.55 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $173.78 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $120.23 | $173.78 | $208.93 |
Where Missouri sits
The same service costs 4.0 times more in Alaska than in Kentucky. 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· 24th of 51
$372
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.