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 $295.12 Median $3,162.28 Typical High $6,309.57 | Facility | None | $295.12 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $199.53 Median $251.19 Typical High $588.84 | Professional | None | $199.53 | $251.19 | $588.84 |
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 $275.42 Median $338.84 Typical High $512.86 | Professional | None | $275.42 | $338.84 | $512.86 |
BCBS Kansas City Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $380.19 | Professional | None | $245.47 | $338.84 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $309.03 Typical High $1,659.59 | Facility | None | $204.17 | $309.03 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $588.84 | Professional | None | $257.04 | $346.74 | $588.84 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $398.11 Typical High $2,041.74 | Facility | None | $54.95 | $398.11 | $2,041.74 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $2,089.30 Typical High $2,570.40 | Professional | None | $323.59 | $2,089.30 | $2,570.40 |
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 $234.42 Median $354.81 Typical High $616.60 | Professional | None | $234.42 | $354.81 | $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 $100.00 Median $125.89 Typical High $151.36 | Professional | 52 · Reduced service | $100.00 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $50.12 Typical High $60.26 | Professional | 53 · Discontinued | $40.74 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $190.55 Typical High $229.09 | Professional | 54 · Surgery only | $151.36 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $38.02 Typical High $45.71 | Professional | 55 · Aftercare only | $30.20 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.95 Median $25.12 Typical High $30.20 | Professional | 56 · Pre-op care only | $19.95 | $25.12 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $177.83 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $141.25 | $177.83 | $213.80 |
Where Missouri sits
The same service costs 4.7 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· 29th of 51
$355
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.