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 $691.83 Median $4,677.35 Typical High $7,762.47 | Facility | None | $691.83 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $1,000.00 | Professional | None | $478.63 | $616.60 | $1,000.00 |
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 $588.84 Median $724.44 Typical High $1,174.90 | Professional | None | $588.84 | $724.44 | $1,174.90 |
BCBS Kansas City Setting Professional Modifier None Typical Low $575.44 Median $776.25 Typical High $891.25 | Professional | None | $575.44 | $776.25 | $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 $602.56 Median $794.33 Typical High $1,380.38 | Professional | None | $602.56 | $794.33 | $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 $741.31 Median $4,786.30 Typical High $5,888.44 | Professional | None | $741.31 | $4,786.30 | $5,888.44 |
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 $1,479.11 | Professional | None | $588.84 | $831.76 | $1,479.11 |
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 $239.88 Median $288.40 Typical High $346.74 | Professional | 52 · Reduced service | $239.88 | $288.40 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $114.82 Typical High $138.04 | Professional | 53 · Discontinued | $95.50 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $426.58 Typical High $524.81 | Professional | 54 · Surgery only | $354.81 | $426.58 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $85.11 Typical High $104.71 | Professional | 55 · Aftercare only | $70.79 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $57.54 Typical High $69.18 | Professional | 56 · Pre-op care only | $47.86 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $398.11 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $331.13 | $398.11 | $489.78 |
Where Missouri sits
The same service costs 4.5 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· 31st of 51
$813
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.