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 $371.54 Median $3,162.28 Typical High $7,762.47 | Facility | None | $371.54 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $323.59 Typical High $478.63 | Professional | None | $263.03 | $323.59 | $478.63 |
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 $288.40 Median $338.84 Typical High $478.63 | Professional | None | $288.40 | $338.84 | $478.63 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $512.86 Typical High $724.44 | Professional | 50 · Both sides | $436.52 | $512.86 | $724.44 |
BCBS Kansas City Setting Professional Modifier None Typical Low $309.03 Median $371.54 Typical High $478.63 | Professional | None | $309.03 | $371.54 | $478.63 |
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 $257.04 Median $346.74 Typical High $616.60 | Professional | None | $257.04 | $346.74 | $616.60 |
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 $346.74 Median $2,290.87 Typical High $2,511.89 | Professional | None | $346.74 | $2,290.87 | $2,511.89 |
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 $275.42 Median $371.54 Typical High $645.65 | Professional | None | $275.42 | $371.54 | $645.65 |
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 $128.82 Median $154.88 Typical High $177.83 | Professional | 52 · Reduced service | $128.82 | $154.88 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $63.10 Typical High $70.79 | Professional | 53 · Discontinued | $52.48 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $234.42 Typical High $263.03 | Professional | 54 · Surgery only | $194.98 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $46.77 Typical High $52.48 | Professional | 55 · Aftercare only | $38.90 | $46.77 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $31.62 Typical High $35.48 | Professional | 56 · Pre-op care only | $26.30 | $31.62 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $181.97 Median $218.78 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $181.97 | $218.78 | $245.47 |
Where Missouri sits
The same service costs 5.8 times more in Alaska than in Utah. 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
$363
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.