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 $245.47 Median $4,677.35 Typical High $7,762.47 | Facility | None | $245.47 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $316.23 | Professional | None | $151.36 | $245.47 | $316.23 |
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 $131.83 Median $316.23 Typical High $501.19 | Professional | None | $131.83 | $316.23 | $501.19 |
BCBS Kansas City Setting Professional Modifier None Typical Low $194.98 Median $309.03 Typical High $363.08 | Professional | None | $194.98 | $309.03 | $363.08 |
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 $213.80 Median $338.84 Typical High $562.34 | Professional | None | $213.80 | $338.84 | $562.34 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $794.33 Typical High $1,949.84 | Facility | None | $54.95 | $794.33 | $1,949.84 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $1,584.89 Typical High $2,511.89 | Professional | None | $363.08 | $1,584.89 | $2,511.89 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $2,344.23 | Facility | None | $398.11 | $1,148.15 | $2,344.23 |
United Setting Professional Modifier None Typical Low $223.87 Median $371.54 Typical High $616.60 | Professional | None | $223.87 | $371.54 | $616.60 |
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 $75.86 Median $123.03 Typical High $147.91 | Professional | 52 · Reduced service | $75.86 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $48.98 Typical High $58.88 | Professional | 53 · Discontinued | $30.20 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $181.97 Typical High $218.78 | Professional | 54 · Surgery only | $114.82 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $36.31 Typical High $43.65 | Professional | 55 · Aftercare only | $22.91 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $24.55 Typical High $29.51 | Professional | 56 · Pre-op care only | $15.14 | $24.55 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $169.82 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $107.15 | $169.82 | $204.17 |
Where Missouri sits
The same service costs 4.1 times more in Alaska than in Kentucky. 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· 25th of 51
$363
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.