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 $676.08 Median $3,311.31 Typical High $7,762.47 | Facility | None | $676.08 | $3,311.31 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $630.96 Typical High $1,023.29 | Professional | None | $489.78 | $630.96 | $1,023.29 |
Ambetter Setting Professional Modifier None Typical Low $724.44 Median $912.01 Typical High $954.99 | Professional | None | $724.44 | $912.01 | $954.99 |
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 $660.69 Median $851.14 Typical High $1,202.26 | Professional | None | $660.69 | $851.14 | $1,202.26 |
BCBS Kansas City Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $891.25 | Professional | None | $588.84 | $758.58 | $891.25 |
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 $616.60 Median $776.25 Typical High $1,380.38 | Professional | None | $616.60 | $776.25 | $1,380.38 |
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 $660.69 Median $1,445.44 Typical High $7,079.46 | Professional | None | $660.69 | $1,445.44 | $7,079.46 |
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 $588.84 Median $831.76 Typical High $1,445.44 | Professional | None | $588.84 | $831.76 | $1,445.44 |
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 $245.47 Median $288.40 Typical High $338.84 | Professional | 52 · Reduced service | $245.47 | $288.40 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $114.82 Typical High $134.90 | Professional | 53 · Discontinued | $97.72 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $436.52 Typical High $512.86 | Professional | 54 · Surgery only | $363.08 | $436.52 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $87.10 Typical High $102.33 | Professional | 55 · Aftercare only | $72.44 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $57.54 Typical High $67.61 | Professional | 56 · Pre-op care only | $48.98 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $407.38 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $338.84 | $407.38 | $478.63 |
Where Missouri sits
The same service costs 4.6 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· 28th of 51
$871
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.