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 $181.97 Median $3,162.28 Typical High $7,762.47 | Facility | None | $181.97 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $151.36 Typical High $263.03 | Professional | None | $95.50 | $151.36 | $263.03 |
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 $138.04 Median $190.55 Typical High $302.00 | Professional | None | $138.04 | $190.55 | $302.00 |
BCBS Kansas City Setting Professional Modifier None Typical Low $112.20 Median $199.53 Typical High $223.87 | Professional | None | $112.20 | $199.53 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $134.90 Typical High $194.98 | Facility | None | $58.88 | $134.90 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $309.03 | Professional | None | $131.83 | $194.98 | $309.03 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $331.13 Typical High $1,288.25 | Facility | None | $54.95 | $331.13 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $977.24 Typical High $1,548.82 | Professional | None | $181.97 | $977.24 | $1,548.82 |
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 $120.23 Median $190.55 Typical High $338.84 | Professional | None | $120.23 | $190.55 | $338.84 |
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 $47.86 Median $75.86 Typical High $91.20 | Professional | 52 · Reduced service | $47.86 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $30.20 Typical High $36.31 | Professional | 53 · Discontinued | $19.05 | $30.20 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $114.82 Typical High $138.04 | Professional | 54 · Surgery only | $70.79 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $22.91 Typical High $27.54 | Professional | 55 · Aftercare only | $14.13 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $15.14 Typical High $18.20 | Professional | 56 · Pre-op care only | $9.55 | $15.14 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $107.15 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $66.07 | $107.15 | $128.82 |
Where Missouri sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 23rd of 51
$209
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.