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 $131.83 Median $3,162.28 Typical High $7,762.47 | Facility | None | $131.83 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $109.65 Typical High $173.78 | Professional | None | $69.18 | $109.65 | $173.78 |
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 $100.00 Median $134.90 Typical High $218.78 | Professional | None | $100.00 | $134.90 | $218.78 |
BCBS Kansas City Setting Professional Modifier None Typical Low $83.18 Median $144.54 Typical High $162.18 | Professional | None | $83.18 | $144.54 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $102.33 Typical High $144.54 | Facility | None | $58.88 | $102.33 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $147.91 Typical High $229.09 | Professional | None | $97.72 | $147.91 | $229.09 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $288.40 Typical High $1,380.38 | Facility | None | $54.95 | $288.40 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $131.83 Median $707.95 Typical High $1,122.02 | Professional | None | $131.83 | $707.95 | $1,122.02 |
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 $87.10 Median $141.25 Typical High $245.47 | Professional | None | $87.10 | $141.25 | $245.47 |
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 $34.67 Median $54.95 Typical High $66.07 | Professional | 52 · Reduced service | $34.67 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $21.88 Typical High $26.30 | Professional | 53 · Discontinued | $13.80 | $21.88 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $83.18 Typical High $100.00 | Professional | 54 · Surgery only | $52.48 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $16.60 Typical High $19.95 | Professional | 55 · Aftercare only | $10.47 | $16.60 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $10.96 Typical High $13.18 | Professional | 56 · Pre-op care only | $6.92 | $10.96 | $13.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $48.98 Median $77.62 Typical High $93.33 | Professional | 78 · Unplanned return to OR | $48.98 | $77.62 | $93.33 |
Where Missouri sits
The same service costs 3.5 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· 24th of 51
$151
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.