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 $1,698.24 Median $5,623.41 Typical High $10,715.19 | Facility | None | $1,698.24 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,023.29 | Professional | None | $724.44 | $870.96 | $1,023.29 |
Ambetter Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
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 $794.33 Median $891.25 Typical High $1,288.25 | Professional | None | $794.33 | $891.25 | $1,288.25 |
BCBS Kansas City Setting Professional Modifier None Typical Low $812.83 Median $870.96 Typical High $1,148.15 | Professional | None | $812.83 | $870.96 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,089.30 Typical High $3,311.31 | Facility | None | $758.58 | $2,089.30 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $933.25 Typical High $1,737.80 | Professional | None | $724.44 | $933.25 | $1,737.80 |
Medica Setting Facility Modifier None Typical Low $645.65 Median $1,862.09 Typical High $8,912.51 | Facility | None | $645.65 | $1,862.09 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $851.14 Median $1,445.44 Typical High $6,760.83 | Professional | None | $851.14 | $1,445.44 | $6,760.83 |
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 $758.58 Median $1,071.52 Typical High $1,737.80 | Professional | None | $758.58 | $1,071.52 | $1,737.80 |
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 $363.08 Median $436.52 Typical High $478.63 | Professional | 52 · Reduced service | $363.08 | $436.52 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $173.78 Typical High $190.55 | Professional | 53 · Discontinued | $144.54 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $549.54 Median $660.69 Typical High $724.44 | Professional | 54 · Surgery only | $549.54 | $660.69 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $109.65 Median $131.83 Typical High $144.54 | Professional | 55 · Aftercare only | $109.65 | $131.83 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $87.10 Typical High $95.50 | Professional | 56 · Pre-op care only | $72.44 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $512.86 Median $616.60 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $512.86 | $616.60 | $676.08 |
Where Missouri sits
The same service costs 7.1 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· 33rd of 51
$977
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.