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 $91.20 Median $4,677.35 Typical High $7,762.47 | Facility | None | $91.20 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $123.03 | Professional | None | $67.61 | $91.20 | $123.03 |
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 $87.10 Median $112.20 Typical High $186.21 | Professional | None | $87.10 | $112.20 | $186.21 |
BCBS Kansas City Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $134.90 | Professional | None | $79.43 | $120.23 | $134.90 |
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 $95.50 Median $125.89 Typical High $208.93 | Professional | None | $95.50 | $125.89 | $208.93 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $281.84 Typical High $1,288.25 | Facility | None | $54.95 | $281.84 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $691.83 Typical High $933.25 | Professional | None | $114.82 | $691.83 | $933.25 |
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 $85.11 Median $125.89 Typical High $213.80 | Professional | None | $85.11 | $125.89 | $213.80 |
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 $33.88 Median $45.71 Typical High $54.95 | Professional | 52 · Reduced service | $33.88 | $45.71 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $18.20 Typical High $21.88 | Professional | 53 · Discontinued | $13.49 | $18.20 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $67.61 Typical High $83.18 | Professional | 54 · Surgery only | $51.29 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $13.80 Typical High $16.60 | Professional | 55 · Aftercare only | $10.23 | $13.80 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $9.12 Typical High $10.96 | Professional | 56 · Pre-op care only | $6.76 | $9.12 | $10.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $47.86 Median $63.10 Typical High $77.62 | Professional | 78 · Unplanned return to OR | $47.86 | $63.10 | $77.62 |
Where Missouri sits
The same service costs 3.8 times more in Alaska than in New York. 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· 27th of 51
$126
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.