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 $794.33 Median $4,677.35 Typical High $7,762.47 | Facility | None | $794.33 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $741.31 Typical High $1,202.26 | Professional | None | $562.34 | $741.31 | $1,202.26 |
Ambetter Setting Professional Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,096.48 | Professional | None | $977.24 | $1,096.48 | $1,096.48 |
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 $758.58 Median $977.24 Typical High $1,412.54 | Professional | None | $758.58 | $977.24 | $1,412.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $1,023.29 | Professional | None | $676.08 | $912.01 | $1,023.29 |
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 $707.95 Median $933.25 Typical High $1,584.89 | Professional | None | $707.95 | $933.25 | $1,584.89 |
Medica Setting Facility Modifier None Typical Low $645.65 Median $1,737.80 Typical High $26,302.68 | Facility | None | $645.65 | $1,737.80 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $5,623.41 Typical High $6,918.31 | Professional | None | $851.14 | $5,623.41 | $6,918.31 |
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 $676.08 Median $954.99 Typical High $1,737.80 | Professional | None | $676.08 | $954.99 | $1,737.80 |
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 $275.42 Median $338.84 Typical High $407.38 | Professional | 52 · Reduced service | $275.42 | $338.84 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $134.90 Typical High $162.18 | Professional | 53 · Discontinued | $112.20 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $501.19 Typical High $616.60 | Professional | 54 · Surgery only | $416.87 | $501.19 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $102.33 Typical High $123.03 | Professional | 55 · Aftercare only | $83.18 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $67.61 Typical High $81.28 | Professional | 56 · Pre-op care only | $56.23 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $467.74 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $389.05 | $467.74 | $575.44 |
Where Missouri sits
The same service costs 4.4 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· 27th of 51
$1,023
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.