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 $389.05 Median $3,162.28 Typical High $7,762.47 | Facility | None | $389.05 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $407.38 | Professional | None | $218.78 | $309.03 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $331.13 Typical High $446.68 | Professional | None | $269.15 | $331.13 | $446.68 |
BCBS Kansas City Setting Professional Modifier None Typical Low $245.47 Median $380.19 Typical High $467.74 | Professional | None | $245.47 | $380.19 | $467.74 |
Cigna Setting Facility Modifier None Typical Low $257.04 Median $389.05 Typical High $2,691.53 | Facility | None | $257.04 | $389.05 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $380.19 Typical High $616.60 | Professional | None | $218.78 | $380.19 | $616.60 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,659.59 Typical High $3,467.37 | Facility | None | $54.95 | $1,659.59 | $3,467.37 |
Medica Setting Professional Modifier None Typical Low $416.87 Median $1,949.84 Typical High $2,754.23 | Professional | None | $416.87 | $1,949.84 | $2,754.23 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $275.42 Median $416.87 Typical High $616.60 | Professional | None | $275.42 | $416.87 | $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 $109.65 Median $154.88 Typical High $194.98 | Professional | 52 · Reduced service | $109.65 | $154.88 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $61.66 Typical High $77.62 | Professional | 53 · Discontinued | $43.65 | $61.66 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $234.42 Typical High $288.40 | Professional | 54 · Surgery only | $162.18 | $234.42 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $46.77 Typical High $57.54 | Professional | 55 · Aftercare only | $33.11 | $46.77 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $30.90 Typical High $38.90 | Professional | 56 · Pre-op care only | $21.88 | $30.90 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $218.78 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $151.36 | $218.78 | $269.15 |
Where Missouri sits
The same service costs 5.2 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· 28th of 51
$407
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.