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 $281.84 Median $4,677.35 Typical High $7,762.47 | Facility | None | $281.84 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $281.84 Typical High $371.54 | Professional | None | $158.49 | $281.84 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $1,621.81 Typical High $3,890.45 | Facility | None | $151.36 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $204.17 Median $316.23 Typical High $524.81 | Professional | None | $204.17 | $316.23 | $524.81 |
BCBS Kansas City Setting Professional Modifier None Typical Low $199.53 Median $363.08 Typical High $416.87 | Professional | None | $199.53 | $363.08 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $66.07 | Facility | None | $50.12 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $363.08 Typical High $602.56 | Professional | None | $218.78 | $363.08 | $602.56 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $446.68 Typical High $1,318.26 | Facility | None | $54.95 | $446.68 | $1,318.26 |
Medica Setting Professional Modifier None Typical Low $389.05 Median $3,890.45 Typical High $3,981.07 | Professional | None | $389.05 | $3,890.45 | $3,981.07 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,137.96 | Facility | None | $123.03 | $602.56 | $2,137.96 |
United Setting Professional Modifier None Typical Low $213.80 Median $398.11 Typical High $660.69 | Professional | None | $213.80 | $398.11 | $660.69 |
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 $79.43 Median $141.25 Typical High $169.82 | Professional | 52 · Reduced service | $79.43 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $57.54 Typical High $69.18 | Professional | 53 · Discontinued | $31.62 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $213.80 Typical High $257.04 | Professional | 54 · Surgery only | $117.49 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $42.66 Typical High $51.29 | Professional | 55 · Aftercare only | $23.44 | $42.66 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $28.18 Typical High $33.88 | Professional | 56 · Pre-op care only | $15.85 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $199.53 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $109.65 | $199.53 | $239.88 |
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· 26th of 51
$372
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.