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 $1,148.15 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,148.15 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $575.44 | Professional | None | $416.87 | $501.19 | $575.44 |
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 $457.09 Median $549.54 Typical High $794.33 | Professional | None | $457.09 | $549.54 | $794.33 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $691.83 Median $812.83 Typical High $1,202.26 | Professional | 50 · Both sides | $691.83 | $812.83 | $1,202.26 |
BCBS Kansas City Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $676.08 | Professional | None | $478.63 | $512.86 | $676.08 |
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 $416.87 Median $512.86 Typical High $977.24 | Professional | None | $416.87 | $512.86 | $977.24 |
Medica Setting Facility Modifier None Typical Low $562.34 Median $1,819.70 Typical High $12,022.64 | Facility | None | $562.34 | $1,819.70 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $812.83 Typical High $3,715.35 | Professional | None | $478.63 | $812.83 | $3,715.35 |
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 $426.58 Median $602.56 Typical High $977.24 | Professional | None | $426.58 | $602.56 | $977.24 |
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 $208.93 Median $251.19 Typical High $275.42 | Professional | 52 · Reduced service | $208.93 | $251.19 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $100.00 Typical High $112.20 | Professional | 53 · Discontinued | $85.11 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $380.19 Typical High $416.87 | Professional | 54 · Surgery only | $316.23 | $380.19 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $75.86 Typical High $83.18 | Professional | 55 · Aftercare only | $63.10 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $50.12 Typical High $54.95 | Professional | 56 · Pre-op care only | $41.69 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $354.81 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $295.12 | $354.81 | $389.05 |
Where Missouri sits
The same service costs 7.6 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· 32nd of 51
$603
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.