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 $389.05 Median $4,677.35 Typical High $7,762.47 | Facility | None | $389.05 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $389.05 Typical High $512.86 | Professional | None | $302.00 | $389.05 | $512.86 |
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 $363.08 Median $467.74 Typical High $758.58 | Professional | None | $363.08 | $467.74 | $758.58 |
BCBS Kansas City Setting Professional Modifier None Typical Low $363.08 Median $512.86 Typical High $575.44 | Professional | None | $363.08 | $512.86 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $363.08 Typical High $512.86 | Facility | None | $58.88 | $363.08 | $512.86 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $912.01 | Professional | None | $416.87 | $537.03 | $912.01 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $537.03 Typical High $1,862.09 | Facility | None | $54.95 | $537.03 | $1,862.09 |
Medica Setting Professional Modifier None Typical Low $501.19 Median $5,011.87 Typical High $5,128.61 | Professional | None | $501.19 | $5,011.87 | $5,128.61 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,454.71 | Facility | None | $123.03 | $602.56 | $2,454.71 |
United Setting Professional Modifier None Typical Low $363.08 Median $537.03 Typical High $933.25 | Professional | None | $363.08 | $537.03 | $933.25 |
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 $147.91 Median $194.98 Typical High $234.42 | Professional | 52 · Reduced service | $147.91 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $77.62 Typical High $93.33 | Professional | 53 · Discontinued | $60.26 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $288.40 Typical High $354.81 | Professional | 54 · Surgery only | $223.87 | $288.40 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $58.88 Typical High $70.79 | Professional | 55 · Aftercare only | $44.67 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $38.90 Typical High $46.77 | Professional | 56 · Pre-op care only | $30.20 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $269.15 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $208.93 | $269.15 | $331.13 |
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· 27th of 51
$525
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.