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 $588.84 Median $707.95 Typical High $812.83 | Professional | None | $588.84 | $707.95 | $812.83 |
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 $676.08 Median $831.76 Typical High $1,148.15 | Professional | None | $676.08 | $831.76 | $1,148.15 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,023.29 Median $1,258.93 Typical High $1,698.24 | Professional | 50 · Both sides | $1,023.29 | $1,258.93 | $1,698.24 |
BCBS Kansas City Setting Professional Modifier None Typical Low $645.65 Median $691.83 Typical High $912.01 | Professional | None | $645.65 | $691.83 | $912.01 |
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 $575.44 Median $741.31 Typical High $1,412.54 | Professional | None | $575.44 | $741.31 | $1,412.54 |
Medica Setting Facility Modifier None Typical Low $138.04 Median $831.76 Typical High $12,022.64 | Facility | None | $138.04 | $831.76 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $691.83 Median $1,148.15 Typical High $5,128.61 | Professional | None | $691.83 | $1,148.15 | $5,128.61 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $3,548.13 | Facility | None | $123.03 | $602.56 | $3,548.13 |
United Setting Professional Modifier None Typical Low $602.56 Median $870.96 Typical High $1,380.38 | Professional | None | $602.56 | $870.96 | $1,380.38 |
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 $295.12 Median $354.81 Typical High $389.05 | Professional | 52 · Reduced service | $295.12 | $354.81 | $389.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $141.25 Typical High $154.88 | Professional | 53 · Discontinued | $117.49 | $141.25 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $436.52 Median $524.81 Typical High $575.44 | Professional | 54 · Surgery only | $436.52 | $524.81 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $104.71 Typical High $117.49 | Professional | 55 · Aftercare only | $89.13 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $70.79 Typical High $77.62 | Professional | 56 · Pre-op care only | $58.88 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $407.38 Median $489.78 Typical High $537.03 | Professional | 78 · Unplanned return to OR | $407.38 | $489.78 | $537.03 |
Where Missouri sits
The same service costs 8.5 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
$851
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.