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 $354.81 Median $4,677.35 Typical High $7,762.47 | Facility | None | $354.81 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $467.74 | Professional | None | $269.15 | $354.81 | $467.74 |
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 $309.03 Median $501.19 Typical High $741.31 | Professional | None | $309.03 | $501.19 | $741.31 |
BCBS Kansas City Setting Professional Modifier None Typical Low $323.59 Median $467.74 Typical High $524.81 | Professional | None | $323.59 | $467.74 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $426.58 Typical High $1,659.59 | Facility | None | $316.23 | $426.58 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $851.14 | Professional | None | $354.81 | $489.78 | $851.14 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $851.14 Typical High $1,949.84 | Facility | None | $54.95 | $851.14 | $1,949.84 |
Medica Setting Professional Modifier None Typical Low $501.19 Median $2,754.23 Typical High $3,630.78 | Professional | None | $501.19 | $2,754.23 | $3,630.78 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $2,398.83 | Facility | None | $398.11 | $1,148.15 | $2,398.83 |
United Setting Professional Modifier None Typical Low $363.08 Median $549.54 Typical High $912.01 | Professional | None | $363.08 | $549.54 | $912.01 |
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 $134.90 Median $177.83 Typical High $213.80 | Professional | 52 · Reduced service | $134.90 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $70.79 Typical High $85.11 | Professional | 53 · Discontinued | $53.70 | $70.79 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $269.15 Typical High $323.59 | Professional | 54 · Surgery only | $204.17 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $53.70 Typical High $64.57 | Professional | 55 · Aftercare only | $40.74 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $35.48 Typical High $42.66 | Professional | 56 · Pre-op care only | $26.92 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $251.19 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $190.55 | $251.19 | $302.00 |
Where Missouri sits
The same service costs 5.1 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· 26th of 51
$537
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.