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 $794.33 Median $3,715.35 Typical High $7,762.47 | Facility | None | $794.33 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $630.96 Typical High $831.76 | Professional | None | $524.81 | $630.96 | $831.76 |
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 $660.69 Median $831.76 Typical High $1,230.27 | Professional | None | $660.69 | $831.76 | $1,230.27 |
BCBS Kansas City Setting Professional Modifier None Typical Low $676.08 Median $912.01 Typical High $1,047.13 | Professional | None | $676.08 | $912.01 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,584.89 Typical High $2,691.53 | Facility | None | $707.95 | $1,584.89 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $1,479.11 | Professional | None | $660.69 | $870.96 | $1,479.11 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,258.93 Typical High $3,388.44 | Facility | None | $54.95 | $1,258.93 | $3,388.44 |
Medica Setting Professional Modifier None Typical Low $776.25 Median $5,248.07 Typical High $6,456.54 | Professional | None | $776.25 | $5,248.07 | $6,456.54 |
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 $616.60 Median $912.01 Typical High $1,621.81 | Professional | None | $616.60 | $912.01 | $1,621.81 |
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 $263.03 Median $316.23 Typical High $380.19 | Professional | 52 · Reduced service | $263.03 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $128.82 Typical High $154.88 | Professional | 53 · Discontinued | $104.71 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $478.63 Typical High $575.44 | Professional | 54 · Surgery only | $398.11 | $478.63 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $95.50 Typical High $114.82 | Professional | 55 · Aftercare only | $79.43 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $63.10 Typical High $77.62 | Professional | 56 · Pre-op care only | $52.48 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $446.68 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $371.54 | $446.68 | $537.03 |
Where Missouri sits
The same service costs 4.9 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· 32nd of 51
$871
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.