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 $251.19 Median $3,162.28 Typical High $7,762.47 | Facility | None | $251.19 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $204.17 Typical High $263.03 | Professional | None | $169.82 | $204.17 | $263.03 |
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 $158.49 Median $199.53 Typical High $288.40 | Professional | None | $158.49 | $199.53 | $288.40 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $239.88 Median $295.12 Typical High $426.58 | Professional | 50 · Both sides | $239.88 | $295.12 | $426.58 |
BCBS Kansas City Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $331.13 | Professional | None | $204.17 | $263.03 | $331.13 |
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 $169.82 Median $239.88 Typical High $416.87 | Professional | None | $169.82 | $239.88 | $416.87 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $338.84 Typical High $1,288.25 | Facility | None | $54.95 | $338.84 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $1,513.56 Typical High $1,819.70 | Professional | None | $190.55 | $1,513.56 | $1,819.70 |
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 $162.18 Median $223.87 Typical High $426.58 | Professional | None | $162.18 | $223.87 | $426.58 |
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 $85.11 Median $102.33 Typical High $125.89 | Professional | 52 · Reduced service | $85.11 | $102.33 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $40.74 Typical High $50.12 | Professional | 53 · Discontinued | $33.88 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $154.88 Typical High $186.21 | Professional | 54 · Surgery only | $125.89 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $30.90 Typical High $37.15 | Professional | 55 · Aftercare only | $25.12 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $20.42 Typical High $25.12 | Professional | 56 · Pre-op care only | $16.98 | $20.42 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $144.54 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $117.49 | $144.54 | $173.78 |
Where Missouri sits
The same service costs 5.0 times more in Alaska than in Florida. 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· 35th of 51
$229
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.