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 $1,071.52 Median $1,288.25 Typical High $1,584.89 | Professional | None | $1,071.52 | $1,288.25 | $1,584.89 |
Ambetter Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
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 $1,318.26 Median $1,584.89 Typical High $2,089.30 | Professional | None | $1,318.26 | $1,584.89 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,995.26 Median $2,398.83 Typical High $3,162.28 | Professional | 50 · Both sides | $1,995.26 | $2,398.83 | $3,162.28 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $1,659.59 | Professional | None | $1,174.90 | $1,258.93 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $10,232.93 Typical High $19,498.45 | Facility | None | $851.14 | $10,232.93 | $19,498.45 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,380.38 Typical High $2,630.27 | Professional | None | $1,071.52 | $1,380.38 | $2,630.27 |
Medica Setting Facility Modifier None Typical Low $1,288.25 Median $6,025.60 Typical High $34,673.69 | Facility | None | $1,288.25 | $6,025.60 | $34,673.69 |
Medica Setting Professional Modifier None Typical Low $1,288.25 Median $2,187.76 Typical High $9,332.54 | Professional | None | $1,288.25 | $2,187.76 | $9,332.54 |
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 $1,122.02 Median $1,621.81 Typical High $2,570.40 | Professional | None | $1,122.02 | $1,621.81 | $2,570.40 |
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 $812.83 Median $977.24 Typical High $1,071.52 | Professional | 54 · Surgery only | $812.83 | $977.24 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $194.98 Typical High $213.80 | Professional | 55 · Aftercare only | $162.18 | $194.98 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $128.82 Typical High $141.25 | Professional | 56 · Pre-op care only | $107.15 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $912.01 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $758.58 | $912.01 | $1,000.00 |
Where Missouri sits
The same service costs 8.1 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· 27th of 51
$1,660
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.