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 $223.87 Median $3,715.35 Typical High $7,762.47 | Facility | None | $223.87 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $177.83 Typical High $251.19 | Professional | None | $123.03 | $177.83 | $251.19 |
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 $181.97 Typical High $295.12 | Professional | None | $144.54 | $181.97 | $295.12 |
BCBS Kansas City Setting Professional Modifier None Typical Low $144.54 Median $223.87 Typical High $275.42 | Professional | None | $144.54 | $223.87 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $234.42 Typical High $1,659.59 | Facility | None | $158.49 | $234.42 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $208.93 Typical High $338.84 | Professional | None | $123.03 | $208.93 | $338.84 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $676.08 Typical High $2,754.23 | Facility | None | $54.95 | $676.08 | $2,754.23 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $1,096.48 Typical High $1,659.59 | Professional | None | $223.87 | $1,096.48 | $1,659.59 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $2,398.83 | Facility | None | $398.11 | $1,148.15 | $2,398.83 |
United Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $338.84 | Professional | None | $147.91 | $223.87 | $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 $61.66 Median $91.20 Typical High $112.20 | Professional | 52 · Reduced service | $61.66 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $36.31 Typical High $44.67 | Professional | 53 · Discontinued | $24.55 | $36.31 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $138.04 Typical High $169.82 | Professional | 54 · Surgery only | $93.33 | $138.04 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $27.54 Typical High $33.88 | Professional | 55 · Aftercare only | $18.62 | $27.54 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $18.20 Typical High $22.39 | Professional | 56 · Pre-op care only | $12.30 | $18.20 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $128.82 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $87.10 | $128.82 | $158.49 |
Where Missouri sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 33rd 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.