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 $676.08 Median $5,623.41 Typical High $10,715.19 | Facility | None | $676.08 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $724.44 | Professional | None | $407.38 | $549.54 | $724.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $630.96 Typical High $933.25 | Professional | None | $489.78 | $630.96 | $933.25 |
BCBS Kansas City Setting Professional Modifier None Typical Low $467.74 Median $645.65 Typical High $812.83 | Professional | None | $467.74 | $645.65 | $812.83 |
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 $426.58 Median $676.08 Typical High $1,122.02 | Professional | None | $426.58 | $676.08 | $1,122.02 |
Medica Setting Facility Modifier None Typical Low $831.76 Median $2,344.23 Typical High $26,302.68 | Facility | None | $831.76 | $2,344.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $741.31 Median $3,715.35 Typical High $4,897.79 | Professional | None | $741.31 | $3,715.35 | $4,897.79 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $501.19 Median $741.31 Typical High $1,096.48 | Professional | None | $501.19 | $741.31 | $1,096.48 |
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 $204.17 Median $275.42 Typical High $338.84 | Professional | 52 · Reduced service | $204.17 | $275.42 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $109.65 Typical High $134.90 | Professional | 53 · Discontinued | $81.28 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $416.87 Typical High $512.86 | Professional | 54 · Surgery only | $309.03 | $416.87 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $83.18 Typical High $102.33 | Professional | 55 · Aftercare only | $61.66 | $83.18 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $54.95 Typical High $67.61 | Professional | 56 · Pre-op care only | $40.74 | $54.95 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $389.05 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $288.40 | $389.05 | $478.63 |
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· 26th of 51
$776
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.