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 $1,778.28 Median $5,623.41 Typical High $11,481.54 | Facility | None | $1,778.28 | $5,623.41 | $11,481.54 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,071.52 Typical High $1,621.81 | Professional | None | $891.25 | $1,071.52 | $1,621.81 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $5,370.32 Typical High $16,982.44 | Facility | None | $1,412.54 | $5,370.32 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,071.52 Median $1,288.25 Typical High $1,737.80 | Professional | None | $1,071.52 | $1,288.25 | $1,737.80 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,621.81 Median $1,949.84 Typical High $2,630.27 | Professional | 50 · Both sides | $1,621.81 | $1,949.84 | $2,630.27 |
BCBS Kansas City Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $1,380.38 | Professional | None | $977.24 | $1,047.13 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $4,168.69 Typical High $10,471.29 | Facility | None | $851.14 | $4,168.69 | $10,471.29 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $2,137.96 | Professional | None | $891.25 | $1,148.15 | $2,137.96 |
Medica Setting Facility Modifier None Typical Low $1,174.90 Median $5,011.87 Typical High $33,884.42 | Facility | None | $1,174.90 | $5,011.87 | $33,884.42 |
Medica Setting Professional Modifier None Typical Low $1,047.13 Median $1,778.28 Typical High $7,762.47 | Professional | None | $1,047.13 | $1,778.28 | $7,762.47 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $5,248.07 Typical High $13,489.63 | Facility | None | $1,174.90 | $5,248.07 | $13,489.63 |
United Setting Professional Modifier None Typical Low $933.25 Median $1,318.26 Typical High $2,089.30 | Professional | None | $933.25 | $1,318.26 | $2,089.30 |
4 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 54 · Surgery only Typical Low $660.69 Median $794.33 Typical High $870.96 | Professional | 54 · Surgery only | $660.69 | $794.33 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $158.49 Typical High $177.83 | Professional | 55 · Aftercare only | $134.90 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $107.15 Typical High $117.49 | Professional | 56 · Pre-op care only | $89.13 | $107.15 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $616.60 Median $741.31 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $616.60 | $741.31 | $812.83 |
Where Missouri sits
The same service costs 7.6 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· 30th of 51
$1,380
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.