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 $489.78 Median $3,715.35 Typical High $7,762.47 | Facility | None | $489.78 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $389.05 Typical High $512.86 | Professional | None | $309.03 | $389.05 | $512.86 |
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 $281.84 Median $426.58 Typical High $602.56 | Professional | None | $281.84 | $426.58 | $602.56 |
BCBS Kansas City Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $602.56 | Professional | None | $338.84 | $478.63 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $2,187.76 | Facility | None | $602.56 | $1,819.70 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $478.63 Typical High $870.96 | Professional | None | $302.00 | $478.63 | $870.96 |
Medica Setting Facility Modifier None Typical Low $616.60 Median $2,570.40 Typical High $16,218.10 | Facility | None | $616.60 | $2,570.40 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $537.03 Median $3,090.30 Typical High $3,467.37 | Professional | None | $537.03 | $3,090.30 | $3,467.37 |
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 $380.19 Median $537.03 Typical High $812.83 | Professional | None | $380.19 | $537.03 | $812.83 |
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 $154.88 Median $194.98 Typical High $245.47 | Professional | 52 · Reduced service | $154.88 | $194.98 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $77.62 Typical High $97.72 | Professional | 53 · Discontinued | $61.66 | $77.62 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $295.12 Typical High $363.08 | Professional | 54 · Surgery only | $229.09 | $295.12 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $58.88 Typical High $72.44 | Professional | 55 · Aftercare only | $45.71 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $38.90 Typical High $48.98 | Professional | 56 · Pre-op care only | $30.90 | $38.90 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $275.42 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $213.80 | $275.42 | $338.84 |
Where Missouri sits
The same service costs 6.0 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· 31st of 51
$525
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.