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 $123.03 Median $3,162.28 Typical High $7,762.47 | Facility | None | $123.03 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $102.33 Typical High $194.98 | Professional | None | $63.10 | $102.33 | $194.98 |
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 $91.20 Median $125.89 Typical High $199.53 | Professional | None | $91.20 | $125.89 | $199.53 |
BCBS Kansas City Setting Professional Modifier None Typical Low $75.86 Median $134.90 Typical High $151.36 | Professional | None | $75.86 | $134.90 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $66.07 | Facility | None | $50.12 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $131.83 Typical High $218.78 | Professional | None | $89.13 | $131.83 | $218.78 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $281.84 Typical High $1,380.38 | Facility | None | $54.95 | $281.84 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $645.65 Typical High $1,047.13 | Professional | None | $125.89 | $645.65 | $1,047.13 |
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 $79.43 Median $131.83 Typical High $229.09 | Professional | None | $79.43 | $131.83 | $229.09 |
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 $31.62 Median $51.29 Typical High $61.66 | Professional | 52 · Reduced service | $31.62 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $20.42 Typical High $24.55 | Professional | 53 · Discontinued | $12.59 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $77.62 Typical High $93.33 | Professional | 54 · Surgery only | $46.77 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $15.49 Typical High $18.62 | Professional | 55 · Aftercare only | $9.33 | $15.49 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $10.23 Typical High $12.30 | Professional | 56 · Pre-op care only | $6.31 | $10.23 | $12.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $43.65 Median $72.44 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $43.65 | $72.44 | $87.10 |
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· 26th of 51
$141
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.