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 $851.14 Median $5,248.07 Typical High $13,803.84 | Facility | None | $851.14 | $5,248.07 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $676.08 Typical High $891.25 | Professional | None | $537.03 | $676.08 | $891.25 |
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 $616.60 Median $776.25 Typical High $1,047.13 | Professional | None | $616.60 | $776.25 | $1,047.13 |
BCBS Kansas City Setting Professional Modifier None Typical Low $575.44 Median $794.33 Typical High $1,000.00 | Professional | None | $575.44 | $794.33 | $1,000.00 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $954.99 Typical High $5,248.07 | Facility | None | $645.65 | $954.99 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $831.76 Typical High $1,380.38 | Professional | None | $537.03 | $831.76 | $1,380.38 |
Medica Setting Facility Modifier None Typical Low $630.96 Median $1,698.24 Typical High $26,302.68 | Facility | None | $630.96 | $1,698.24 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $6,025.60 Typical High $6,760.83 | Professional | None | $851.14 | $6,025.60 | $6,760.83 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,235.94 | Facility | None | $562.34 | $1,513.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $602.56 Median $891.25 Typical High $1,412.54 | Professional | None | $602.56 | $891.25 | $1,412.54 |
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 $269.15 Median $338.84 Typical High $416.87 | Professional | 52 · Reduced service | $269.15 | $338.84 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $134.90 Typical High $169.82 | Professional | 53 · Discontinued | $109.65 | $134.90 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $512.86 Typical High $630.96 | Professional | 54 · Surgery only | $407.38 | $512.86 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $102.33 Typical High $125.89 | Professional | 55 · Aftercare only | $81.28 | $102.33 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $67.61 Typical High $85.11 | Professional | 56 · Pre-op care only | $53.70 | $67.61 | $85.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $478.63 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $380.19 | $478.63 | $588.84 |
Where Missouri sits
The same service costs 5.6 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
$912
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.