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 $275.42 Median $3,162.28 Typical High $6,309.57 | Facility | None | $275.42 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $234.42 Typical High $288.40 | Professional | None | $194.98 | $234.42 | $288.40 |
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 $229.09 Median $275.42 Typical High $389.05 | Professional | None | $229.09 | $275.42 | $389.05 |
BCBS Kansas City Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $354.81 | Professional | None | $229.09 | $275.42 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $141.25 Typical High $199.53 | Facility | None | $58.88 | $141.25 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $275.42 Typical High $489.78 | Professional | None | $213.80 | $275.42 | $489.78 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $354.81 Typical High $1,548.82 | Facility | None | $54.95 | $354.81 | $1,548.82 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $1,737.80 Typical High $1,995.26 | Professional | None | $288.40 | $1,737.80 | $1,995.26 |
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 $213.80 Median $302.00 Typical High $489.78 | Professional | None | $213.80 | $302.00 | $489.78 |
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 $97.72 Median $117.49 Typical High $134.90 | Professional | 52 · Reduced service | $97.72 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $46.77 Typical High $54.95 | Professional | 53 · Discontinued | $38.90 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $177.83 Typical High $204.17 | Professional | 54 · Surgery only | $144.54 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $35.48 Typical High $40.74 | Professional | 55 · Aftercare only | $28.84 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $23.44 Typical High $27.54 | Professional | 56 · Pre-op care only | $19.50 | $23.44 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $165.96 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $134.90 | $165.96 | $190.55 |
Where Missouri sits
The same service costs 5.1 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· 30th of 51
$302
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.