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 $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,288.25 | Professional | None | $891.25 | $1,071.52 | $1,288.25 |
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 $812.83 Median $1,071.52 Typical High $1,513.56 | Professional | None | $812.83 | $1,071.52 | $1,513.56 |
BCBS Kansas City Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $1,380.38 | Professional | None | $977.24 | $1,047.13 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,691.53 Typical High $3,388.44 | Facility | None | $645.65 | $2,691.53 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,148.15 Typical High $2,187.76 | Professional | None | $794.33 | $1,148.15 | $2,187.76 |
Medica Setting Facility Modifier None Typical Low $645.65 Median $1,862.09 Typical High $26,302.68 | Facility | None | $645.65 | $1,862.09 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $954.99 Median $1,737.80 Typical High $7,943.28 | Professional | None | $954.99 | $1,737.80 | $7,943.28 |
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 $891.25 Median $1,288.25 Typical High $2,137.96 | Professional | None | $891.25 | $1,288.25 | $2,137.96 |
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 $446.68 Median $537.03 Typical High $588.84 | Professional | 52 · Reduced service | $446.68 | $537.03 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $213.80 Typical High $239.88 | Professional | 53 · Discontinued | $181.97 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $812.83 Typical High $891.25 | Professional | 54 · Surgery only | $676.08 | $812.83 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $162.18 Typical High $177.83 | Professional | 55 · Aftercare only | $134.90 | $162.18 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $107.15 Typical High $117.49 | Professional | 56 · Pre-op care only | $89.13 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $758.58 Typical High $831.76 | Professional | 78 · Unplanned return to OR | $630.96 | $758.58 | $831.76 |
Where Missouri sits
The same service costs 7.8 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
$1,175
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.