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 $223.87 Median $2,951.21 Typical High $6,309.57 | Facility | None | $223.87 | $2,951.21 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $223.87 Typical High $295.12 | Professional | None | $131.83 | $223.87 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $165.96 Typical High $251.19 | Professional | None | $151.36 | $165.96 | $251.19 |
BCBS Kansas City Setting Professional Modifier None Typical Low $144.54 Median $263.03 Typical High $331.13 | Professional | None | $144.54 | $263.03 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $954.99 Typical High $1,659.59 | Facility | None | $446.68 | $954.99 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $229.09 Typical High $389.05 | Professional | None | $128.82 | $229.09 | $389.05 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,023.29 Typical High $3,090.30 | Facility | None | $54.95 | $1,023.29 | $3,090.30 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $1,174.90 Typical High $1,995.26 | Professional | None | $275.42 | $1,174.90 | $1,995.26 |
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 $158.49 Median $245.47 Typical High $407.38 | Professional | None | $158.49 | $245.47 | $407.38 |
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 $66.07 Median $112.20 Typical High $138.04 | Professional | 52 · Reduced service | $66.07 | $112.20 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $44.67 Typical High $56.23 | Professional | 53 · Discontinued | $26.30 | $44.67 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $169.82 Typical High $208.93 | Professional | 54 · Surgery only | $97.72 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $33.88 Typical High $41.69 | Professional | 55 · Aftercare only | $19.95 | $33.88 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $22.39 Typical High $27.54 | Professional | 56 · Pre-op care only | $13.18 | $22.39 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $158.49 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $91.20 | $158.49 | $194.98 |
Where Missouri sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 36th of 51
$245
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.