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 $645.65 Median $3,715.35 Typical High $7,762.47 | Facility | None | $645.65 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $524.81 Typical High $691.83 | Professional | None | $295.12 | $524.81 | $691.83 |
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 $295.12 Median $407.38 Typical High $575.44 | Professional | None | $295.12 | $407.38 | $575.44 |
BCBS Kansas City Setting Professional Modifier None Typical Low $346.74 Median $616.60 Typical High $776.25 | Professional | None | $346.74 | $616.60 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,951.21 Typical High $4,365.16 | Facility | None | $602.56 | $2,951.21 | $4,365.16 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $549.54 Typical High $977.24 | Professional | None | $295.12 | $549.54 | $977.24 |
Medica Setting Facility Modifier None Typical Low $851.14 Median $3,801.89 Typical High $16,218.10 | Facility | None | $851.14 | $3,801.89 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $741.31 Median $2,691.53 Typical High $4,570.88 | Professional | None | $741.31 | $2,691.53 | $4,570.88 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,981.07 | $8,709.64 |
United Setting Professional Modifier None Typical Low $371.54 Median $616.60 Typical High $1,023.29 | Professional | None | $371.54 | $616.60 | $1,023.29 |
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 $147.91 Median $263.03 Typical High $323.59 | Professional | 52 · Reduced service | $147.91 | $263.03 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $104.71 Typical High $128.82 | Professional | 53 · Discontinued | $60.26 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $389.05 Typical High $478.63 | Professional | 54 · Surgery only | $223.87 | $389.05 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $77.62 Typical High $95.50 | Professional | 55 · Aftercare only | $44.67 | $77.62 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $52.48 Typical High $64.57 | Professional | 56 · Pre-op care only | $29.51 | $52.48 | $64.57 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $363.08 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $208.93 | $363.08 | $446.68 |
Where Missouri sits
The same service costs 4.9 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· 35th of 51
$617
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.