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 $1,698.24 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $467.74 | Professional | None | $331.13 | $398.11 | $467.74 |
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 $346.74 Median $407.38 Typical High $602.56 | Professional | None | $346.74 | $407.38 | $602.56 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $616.60 Typical High $912.01 | Professional | 50 · Both sides | $524.81 | $616.60 | $912.01 |
BCBS Kansas City Setting Professional Modifier None Typical Low $380.19 Median $407.38 Typical High $537.03 | Professional | None | $380.19 | $407.38 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,630.78 Typical High $5,370.32 | Facility | None | $645.65 | $3,630.78 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $416.87 Typical High $812.83 | Professional | None | $331.13 | $416.87 | $812.83 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $2,754.23 Typical High $26,302.68 | Facility | None | $724.44 | $2,754.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $380.19 Median $660.69 Typical High $3,630.78 | Professional | None | $380.19 | $660.69 | $3,630.78 |
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 $338.84 Median $478.63 Typical High $776.25 | Professional | None | $338.84 | $478.63 | $776.25 |
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 $165.96 Median $199.53 Typical High $218.78 | Professional | 52 · Reduced service | $165.96 | $199.53 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $79.43 Typical High $87.10 | Professional | 53 · Discontinued | $66.07 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $302.00 Typical High $323.59 | Professional | 54 · Surgery only | $245.47 | $302.00 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $60.26 Typical High $64.57 | Professional | 55 · Aftercare only | $48.98 | $60.26 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $39.81 Typical High $43.65 | Professional | 56 · Pre-op care only | $33.11 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $229.09 Median $281.84 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $229.09 | $281.84 | $302.00 |
Where Missouri sits
The same service costs 7.2 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· 34th of 51
$457
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.