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 $186.21 Median $3,162.28 Typical High $7,762.47 | Facility | None | $186.21 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $234.42 | Professional | None | $100.00 | $154.88 | $234.42 |
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 $144.54 Median $194.98 Typical High $316.23 | Professional | None | $144.54 | $194.98 | $316.23 |
BCBS Kansas City Setting Professional Modifier None Typical Low $117.49 Median $199.53 Typical High $223.87 | Professional | None | $117.49 | $199.53 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $134.90 Typical High $190.55 | Facility | None | $58.88 | $134.90 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $208.93 Typical High $323.59 | Professional | None | $138.04 | $208.93 | $323.59 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $331.13 Typical High $1,778.28 | Facility | None | $54.95 | $331.13 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $186.21 Median $1,023.29 Typical High $1,584.89 | Professional | None | $186.21 | $1,023.29 | $1,584.89 |
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 $125.89 Median $199.53 Typical High $338.84 | Professional | None | $125.89 | $199.53 | $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 $50.12 Median $75.86 Typical High $93.33 | Professional | 52 · Reduced service | $50.12 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $30.90 Typical High $37.15 | Professional | 53 · Discontinued | $19.95 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $114.82 Typical High $138.04 | Professional | 54 · Surgery only | $74.13 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $22.91 Typical High $27.54 | Professional | 55 · Aftercare only | $15.14 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $15.49 Typical High $18.62 | Professional | 56 · Pre-op care only | $10.00 | $15.49 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $107.15 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $69.18 | $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· 22nd of 51
$214
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.