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 $616.60 Median $3,715.35 Typical High $7,762.47 | Facility | None | $616.60 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $398.11 Typical High $616.60 | Professional | None | $302.00 | $398.11 | $616.60 |
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 $302.00 Median $354.81 Typical High $537.03 | Professional | None | $302.00 | $354.81 | $537.03 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $446.68 Median $537.03 Typical High $794.33 | Professional | 50 · Both sides | $446.68 | $537.03 | $794.33 |
BCBS Kansas City Setting Professional Modifier None Typical Low $354.81 Median $616.60 Typical High $758.58 | Professional | None | $354.81 | $616.60 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,513.56 Typical High $2,187.76 | Facility | None | $602.56 | $1,513.56 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $489.78 Typical High $891.25 | Professional | None | $295.12 | $489.78 | $891.25 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $2,344.23 Typical High $16,218.10 | Facility | None | $588.84 | $2,344.23 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $575.44 Median $2,630.27 Typical High $4,365.16 | Professional | None | $575.44 | $2,630.27 | $4,365.16 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,370.32 | Facility | None | $1,000.00 | $2,818.38 | $5,370.32 |
United Setting Professional Modifier None Typical Low $331.13 Median $549.54 Typical High $912.01 | Professional | None | $331.13 | $549.54 | $912.01 |
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 $151.36 Median $245.47 Typical High $302.00 | Professional | 52 · Reduced service | $151.36 | $245.47 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $100.00 Typical High $123.03 | Professional | 53 · Discontinued | $60.26 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $371.54 Typical High $457.09 | Professional | 54 · Surgery only | $223.87 | $371.54 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $74.13 Typical High $91.20 | Professional | 55 · Aftercare only | $44.67 | $74.13 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $48.98 Typical High $61.66 | Professional | 56 · Pre-op care only | $30.20 | $48.98 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $208.93 Median $346.74 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $208.93 | $346.74 | $426.58 |
Where Missouri sits
The same service costs 4.7 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· 31st of 51
$550
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.