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 $269.15 Median $3,162.28 Typical High $7,762.47 | Facility | None | $269.15 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $218.78 Typical High $281.84 | Professional | None | $131.83 | $218.78 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $1,621.81 Typical High $3,890.45 | Facility | None | $151.36 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $151.36 Median $169.82 Typical High $257.04 | Professional | None | $151.36 | $169.82 | $257.04 |
BCBS Kansas City Setting Professional Modifier None Typical Low $144.54 Median $257.04 Typical High $323.59 | Professional | None | $144.54 | $257.04 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $275.42 Typical High $1,659.59 | Facility | None | $181.97 | $275.42 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $234.42 Typical High $389.05 | Professional | None | $158.49 | $234.42 | $389.05 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $724.44 Typical High $1,995.26 | Facility | None | $54.95 | $724.44 | $1,995.26 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $1,148.15 Typical High $1,905.46 | Professional | None | $275.42 | $1,148.15 | $1,905.46 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $2,398.83 | Facility | None | $398.11 | $1,148.15 | $2,398.83 |
United Setting Professional Modifier None Typical Low $154.88 Median $245.47 Typical High $398.11 | Professional | None | $154.88 | $245.47 | $398.11 |
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 $64.57 Median $107.15 Typical High $134.90 | Professional | 52 · Reduced service | $64.57 | $107.15 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $43.65 Typical High $53.70 | Professional | 53 · Discontinued | $26.30 | $43.65 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $162.18 Typical High $199.53 | Professional | 54 · Surgery only | $97.72 | $162.18 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $32.36 Typical High $39.81 | Professional | 55 · Aftercare only | $19.50 | $32.36 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $21.88 Typical High $26.92 | Professional | 56 · Pre-op care only | $13.18 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $151.36 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $91.20 | $151.36 | $186.21 |
Where Missouri sits
The same service costs 4.4 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
$240
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.