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 $575.44 Median $3,162.28 Typical High $7,762.47 | Facility | None | $575.44 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $501.19 Typical High $588.84 | Professional | None | $416.87 | $501.19 | $588.84 |
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 $467.74 Median $562.34 Typical High $776.25 | Professional | None | $467.74 | $562.34 | $776.25 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $707.95 Median $851.14 Typical High $1,174.90 | Professional | 50 · Both sides | $707.95 | $851.14 | $1,174.90 |
BCBS Kansas City Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $741.31 | Professional | None | $478.63 | $575.44 | $741.31 |
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 $416.87 Median $549.54 Typical High $977.24 | Professional | None | $416.87 | $549.54 | $977.24 |
Medica Setting Facility Modifier None Typical Low $151.36 Median $660.69 Typical High $12,022.64 | Facility | None | $151.36 | $660.69 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $562.34 Median $3,630.78 Typical High $3,890.45 | Professional | None | $562.34 | $3,630.78 | $3,890.45 |
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 $446.68 Median $602.56 Typical High $1,023.29 | Professional | None | $446.68 | $602.56 | $1,023.29 |
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 $281.84 | Professional | 52 · Reduced service | $208.93 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $100.00 Typical High $114.82 | Professional | 53 · Discontinued | $83.18 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $371.54 Typical High $426.58 | Professional | 54 · Surgery only | $309.03 | $371.54 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $74.13 Typical High $85.11 | Professional | 55 · Aftercare only | $61.66 | $74.13 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $50.12 Typical High $56.23 | Professional | 56 · Pre-op care only | $41.69 | $50.12 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $346.74 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $288.40 | $346.74 | $398.11 |
Where Missouri sits
The same service costs 5.8 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· 29th 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.