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 $323.59 Median $3,162.28 Typical High $7,762.47 | Facility | None | $323.59 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $269.15 Typical High $371.54 | Professional | None | $223.87 | $269.15 | $371.54 |
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 $251.19 Median $295.12 Typical High $416.87 | Professional | None | $251.19 | $295.12 | $416.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $380.19 Median $446.68 Typical High $630.96 | Professional | 50 · Both sides | $380.19 | $446.68 | $630.96 |
BCBS Kansas City Setting Professional Modifier None Typical Low $269.15 Median $316.23 Typical High $398.11 | Professional | None | $269.15 | $316.23 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $199.53 Typical High $1,659.59 | Facility | None | $134.90 | $199.53 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $288.40 Typical High $524.81 | Professional | None | $229.09 | $288.40 | $524.81 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $371.54 Typical High $1,584.89 | Facility | None | $54.95 | $371.54 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $1,995.26 Typical High $2,089.30 | Professional | None | $288.40 | $1,995.26 | $2,089.30 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,137.96 | Facility | None | $123.03 | $602.56 | $2,137.96 |
United Setting Professional Modifier None Typical Low $234.42 Median $316.23 Typical High $549.54 | Professional | None | $234.42 | $316.23 | $549.54 |
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 $112.20 Median $134.90 Typical High $151.36 | Professional | 52 · Reduced service | $112.20 | $134.90 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $53.70 Typical High $61.66 | Professional | 53 · Discontinued | $44.67 | $53.70 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $204.17 Typical High $229.09 | Professional | 54 · Surgery only | $169.82 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $40.74 Typical High $45.71 | Professional | 55 · Aftercare only | $33.88 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $26.92 Typical High $30.20 | Professional | 56 · Pre-op care only | $22.39 | $26.92 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $158.49 Median $190.55 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $158.49 | $190.55 | $213.80 |
Where Missouri sits
The same service costs 5.9 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· 30th of 51
$316
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.