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 $338.84 Median $3,715.35 Typical High $6,309.57 | Facility | None | $338.84 | $3,715.35 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $281.84 Typical High $501.19 | Professional | None | $154.88 | $281.84 | $501.19 |
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 $194.98 Median $275.42 Typical High $478.63 | Professional | None | $194.98 | $275.42 | $478.63 |
BCBS Kansas City Setting Professional Modifier None Typical Low $194.98 Median $371.54 Typical High $426.58 | Professional | None | $194.98 | $371.54 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $549.54 Typical High $2,187.76 | Facility | None | $398.11 | $549.54 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $346.74 Typical High $537.03 | Professional | None | $208.93 | $346.74 | $537.03 |
Medica Setting Facility Modifier None Typical Low $151.36 Median $660.69 Typical High $16,218.10 | Facility | None | $151.36 | $660.69 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $1,584.89 Typical High $2,818.38 | Professional | None | $323.59 | $1,584.89 | $2,818.38 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,454.71 | Facility | None | $123.03 | $602.56 | $2,454.71 |
United Setting Professional Modifier None Typical Low $190.55 Median $331.13 Typical High $588.84 | Professional | None | $190.55 | $331.13 | $588.84 |
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 $77.62 Median $131.83 Typical High $169.82 | Professional | 52 · Reduced service | $77.62 | $131.83 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $52.48 Typical High $67.61 | Professional | 53 · Discontinued | $30.90 | $52.48 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $194.98 Typical High $251.19 | Professional | 54 · Surgery only | $117.49 | $194.98 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $38.90 Typical High $50.12 | Professional | 55 · Aftercare only | $23.44 | $38.90 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $26.30 Typical High $33.88 | Professional | 56 · Pre-op care only | $15.49 | $26.30 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $181.97 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $109.65 | $181.97 | $234.42 |
Where Missouri sits
The same service costs 3.4 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· 38th of 51
$331
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.