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 $288.40 Median $3,715.35 Typical High $7,762.47 | Facility | None | $288.40 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $223.87 Typical High $309.03 | Professional | None | $144.54 | $223.87 | $309.03 |
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 $190.55 Median $251.19 Typical High $371.54 | Professional | None | $190.55 | $251.19 | $371.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $177.83 Median $288.40 Typical High $323.59 | Professional | None | $177.83 | $288.40 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $194.98 Typical High $275.42 | Facility | None | $58.88 | $194.98 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $269.15 Typical High $436.52 | Professional | None | $181.97 | $269.15 | $436.52 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $870.96 Typical High $2,630.27 | Facility | None | $54.95 | $870.96 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $1,412.54 Typical High $2,137.96 | Professional | None | $257.04 | $1,412.54 | $2,137.96 |
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 $169.82 Median $275.42 Typical High $467.74 | Professional | None | $169.82 | $275.42 | $467.74 |
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 $72.44 Median $112.20 Typical High $147.91 | Professional | 52 · Reduced service | $72.44 | $112.20 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $44.67 Typical High $58.88 | Professional | 53 · Discontinued | $28.84 | $44.67 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $165.96 Typical High $218.78 | Professional | 54 · Surgery only | $107.15 | $165.96 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $33.11 Typical High $43.65 | Professional | 55 · Aftercare only | $21.38 | $33.11 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $22.39 Typical High $29.51 | Professional | 56 · Pre-op care only | $14.45 | $22.39 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $154.88 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $100.00 | $154.88 | $204.17 |
Where Missouri sits
The same service costs 3.5 times more in Alaska 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· 29th of 51
$295
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.