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 $204.17 Median $3,162.28 Typical High $6,309.57 | Facility | None | $204.17 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $147.91 Typical High $199.53 | Professional | None | $120.23 | $147.91 | $199.53 |
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 $131.83 Median $147.91 Typical High $229.09 | Professional | None | $131.83 | $147.91 | $229.09 |
BCBS Kansas City Setting Professional Modifier None Typical Low $144.54 Median $173.78 Typical High $223.87 | Professional | None | $144.54 | $173.78 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $123.03 Typical High $173.78 | Facility | None | $58.88 | $123.03 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $302.00 | Professional | None | $123.03 | $173.78 | $302.00 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $331.13 Typical High $1,548.82 | Facility | None | $54.95 | $331.13 | $1,548.82 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $1,096.48 Typical High $1,258.93 | Professional | None | $169.82 | $1,096.48 | $1,258.93 |
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 $131.83 Median $186.21 Typical High $309.03 | Professional | None | $131.83 | $186.21 | $309.03 |
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 $61.66 Median $74.13 Typical High $87.10 | Professional | 52 · Reduced service | $61.66 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $29.51 Typical High $34.67 | Professional | 53 · Discontinued | $24.55 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $109.65 Typical High $128.82 | Professional | 54 · Surgery only | $91.20 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $21.88 Typical High $25.70 | Professional | 55 · Aftercare only | $18.20 | $21.88 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $14.79 Typical High $17.38 | Professional | 56 · Pre-op care only | $12.30 | $14.79 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $102.33 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $85.11 | $102.33 | $120.23 |
Where Missouri sits
The same service costs 4.9 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· 34th of 51
$174
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.