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 $295.12 Median $3,162.28 Typical High $7,762.47 | Facility | None | $295.12 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $275.42 | Professional | None | $204.17 | $251.19 | $275.42 |
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 $204.17 Median $239.88 Typical High $363.08 | Professional | None | $204.17 | $239.88 | $363.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $309.03 Median $363.08 Typical High $549.54 | Professional | 50 · Both sides | $309.03 | $363.08 | $549.54 |
BCBS Setting Professional Modifier None Typical Low $245.47 Median $275.42 Typical High $354.81 | Professional | None | $245.47 | $275.42 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,122.02 Typical High $1,659.59 | Facility | None | $446.68 | $1,122.02 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $467.74 | Professional | None | $204.17 | $257.04 | $467.74 |
Medica Setting Facility Modifier None Typical Low $338.84 Median $1,445.44 Typical High $12,022.64 | Facility | None | $338.84 | $1,445.44 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $245.47 Median $1,819.70 Typical High $1,862.09 | Professional | None | $245.47 | $1,819.70 | $1,862.09 |
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 $208.93 Median $281.84 Typical High $489.78 | Professional | None | $208.93 | $281.84 | $489.78 |
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 $102.33 Median $125.89 Typical High $138.04 | Professional | 52 · Reduced service | $102.33 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $50.12 Typical High $54.95 | Professional | 53 · Discontinued | $40.74 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $186.21 Typical High $204.17 | Professional | 54 · Surgery only | $154.88 | $186.21 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $37.15 Typical High $40.74 | Professional | 55 · Aftercare only | $30.90 | $37.15 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $25.12 Typical High $27.54 | Professional | 56 · Pre-op care only | $20.42 | $25.12 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $173.78 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $144.54 | $173.78 | $190.55 |
Where Missouri sits
The same service costs 5.4 times more in Alaska than in Utah. 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· 33rd of 51
$275
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.