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 $741.31 Median $3,715.35 Typical High $7,762.47 | Facility | None | $741.31 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $794.33 | Professional | None | $501.19 | $602.56 | $794.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,479.11 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $457.09 Median $588.84 Typical High $870.96 | Professional | None | $457.09 | $588.84 | $870.96 |
BCBS Kansas City Setting Professional Modifier None Typical Low $562.34 Median $724.44 Typical High $912.01 | Professional | None | $562.34 | $724.44 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $851.14 Typical High $2,187.76 | Facility | None | $588.84 | $851.14 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $707.95 Typical High $1,258.93 | Professional | None | $478.63 | $707.95 | $1,258.93 |
Medica Setting Facility Modifier None Typical Low $616.60 Median $1,698.24 Typical High $16,218.10 | Facility | None | $616.60 | $1,698.24 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $707.95 Median $4,365.16 Typical High $5,248.07 | Professional | None | $707.95 | $4,365.16 | $5,248.07 |
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 $537.03 Median $776.25 Typical High $1,258.93 | Professional | None | $537.03 | $776.25 | $1,258.93 |
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 $245.47 Median $295.12 Typical High $371.54 | Professional | 52 · Reduced service | $245.47 | $295.12 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $120.23 Typical High $147.91 | Professional | 53 · Discontinued | $100.00 | $120.23 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $446.68 Typical High $549.54 | Professional | 54 · Surgery only | $371.54 | $446.68 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $89.13 Typical High $109.65 | Professional | 55 · Aftercare only | $74.13 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $60.26 Typical High $74.13 | Professional | 56 · Pre-op care only | $50.12 | $60.26 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $416.87 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $346.74 | $416.87 | $512.86 |
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· 31st of 51
$724
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.