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 $616.60 Median $4,677.35 Typical High $7,762.47 | Facility | None | $616.60 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $891.25 | Professional | None | $416.87 | $562.34 | $891.25 |
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 $512.86 Median $660.69 Typical High $1,000.00 | Professional | None | $512.86 | $660.69 | $1,000.00 |
BCBS Kansas City Setting Professional Modifier None Typical Low $512.86 Median $691.83 Typical High $794.33 | Professional | None | $512.86 | $691.83 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,445.44 Typical High $2,691.53 | Facility | None | $645.65 | $1,445.44 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $707.95 Typical High $1,202.26 | Professional | None | $537.03 | $707.95 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $602.56 Median $1,698.24 Typical High $26,302.68 | Facility | None | $602.56 | $1,698.24 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $4,168.69 Typical High $5,248.07 | Professional | None | $645.65 | $4,168.69 | $5,248.07 |
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 $489.78 Median $707.95 Typical High $1,288.25 | Professional | None | $489.78 | $707.95 | $1,288.25 |
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 $208.93 Median $257.04 Typical High $309.03 | Professional | 52 · Reduced service | $208.93 | $257.04 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $102.33 Typical High $123.03 | Professional | 53 · Discontinued | $83.18 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $389.05 Typical High $467.74 | Professional | 54 · Surgery only | $309.03 | $389.05 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $77.62 Typical High $93.33 | Professional | 55 · Aftercare only | $61.66 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $51.29 Typical High $61.66 | Professional | 56 · Pre-op care only | $41.69 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $363.08 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $288.40 | $363.08 | $436.52 |
Where Missouri sits
The same service costs 4.3 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· 34th of 51
$708
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.