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 $1,412.54 Median $5,495.41 Typical High $8,912.51 | Facility | None | $1,412.54 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $1,288.25 Typical High $1,905.46 | Professional | None | $398.11 | $1,288.25 | $1,905.46 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,981.07 | Facility | None | $446.68 | $1,621.81 | $3,981.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $676.08 Typical High $1,905.46 | Professional | None | $398.11 | $676.08 | $1,905.46 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $602.56 Median $1,000.00 Typical High $2,818.38 | Professional | 50 · Both sides | $602.56 | $1,000.00 | $2,818.38 |
BCBS Kansas City Setting Professional Modifier None Typical Low $380.19 Median $1,288.25 Typical High $1,698.24 | Professional | None | $380.19 | $1,288.25 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,089.30 Typical High $2,884.03 | Facility | None | $645.65 | $2,089.30 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $954.99 Typical High $2,630.27 | Professional | None | $371.54 | $954.99 | $2,630.27 |
Medica Setting Facility Modifier None Typical Low $891.25 Median $3,019.95 Typical High $26,302.68 | Facility | None | $891.25 | $3,019.95 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $1,778.28 Median $5,754.40 Typical High $8,912.51 | Professional | None | $1,778.28 | $5,754.40 | $8,912.51 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,760.83 | Facility | None | $1,000.00 | $3,467.37 | $6,760.83 |
United Setting Professional Modifier None Typical Low $524.81 Median $1,348.96 Typical High $3,019.95 | Professional | None | $524.81 | $1,348.96 | $3,019.95 |
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 $199.53 Median $323.59 Typical High $741.31 | Professional | 52 · Reduced service | $199.53 | $323.59 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $128.82 Typical High $302.00 | Professional | 53 · Discontinued | $81.28 | $128.82 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $489.78 Typical High $1,122.02 | Professional | 54 · Surgery only | $302.00 | $489.78 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $97.72 Typical High $223.87 | Professional | 55 · Aftercare only | $60.26 | $97.72 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $64.57 Typical High $147.91 | Professional | 56 · Pre-op care only | $39.81 | $64.57 | $147.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $457.09 Typical High $1,047.13 | Professional | 78 · Unplanned return to OR | $281.84 | $457.09 | $1,047.13 |
Where Missouri sits
The same service costs 4.4 times more in Alaska than in Nebraska. 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
$1,349
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.