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 $316.23 Median $3,715.35 Typical High $7,762.47 | Facility | None | $316.23 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $354.81 | Professional | None | $194.98 | $257.04 | $354.81 |
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 $281.84 Median $380.19 Typical High $549.54 | Professional | None | $281.84 | $380.19 | $549.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $234.42 Median $346.74 Typical High $389.05 | Professional | None | $234.42 | $346.74 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $199.53 Typical High $281.84 | Facility | None | $58.88 | $199.53 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $363.08 Typical High $602.56 | Professional | None | $275.42 | $363.08 | $602.56 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $416.87 Typical High $1,949.84 | Facility | None | $54.95 | $416.87 | $1,949.84 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $1,995.26 Typical High $2,630.27 | Professional | None | $331.13 | $1,995.26 | $2,630.27 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,454.71 | Facility | None | $123.03 | $602.56 | $2,454.71 |
United Setting Professional Modifier None Typical Low $245.47 Median $354.81 Typical High $616.60 | Professional | None | $245.47 | $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 $97.72 Median $128.82 Typical High $158.49 | Professional | 52 · Reduced service | $97.72 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $52.48 Typical High $63.10 | Professional | 53 · Discontinued | $38.90 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $147.91 Median $194.98 Typical High $234.42 | Professional | 54 · Surgery only | $147.91 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $38.90 Typical High $46.77 | Professional | 55 · Aftercare only | $29.51 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $25.70 Typical High $31.62 | Professional | 56 · Pre-op care only | $19.50 | $25.70 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $138.04 Median $181.97 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $138.04 | $181.97 | $218.78 |
Where Missouri sits
The same service costs 4.0 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· 26th of 51
$380
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.