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 $1,513.56 Median $5,495.41 Typical High $8,912.51 | Facility | None | $1,513.56 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $1,513.56 Typical High $1,778.28 | Professional | None | $346.74 | $1,513.56 | $1,778.28 |
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 $346.74 Median $588.84 Typical High $2,089.30 | Professional | None | $346.74 | $588.84 | $2,089.30 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $870.96 Typical High $3,090.30 | Professional | 50 · Both sides | $524.81 | $870.96 | $3,090.30 |
BCBS Kansas City Setting Professional Modifier None Typical Low $331.13 Median $1,348.96 Typical High $1,949.84 | Professional | None | $331.13 | $1,348.96 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,089.30 Typical High $2,691.53 | Facility | None | $645.65 | $2,089.30 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $831.76 Typical High $2,884.03 | Professional | None | $323.59 | $831.76 | $2,884.03 |
Medica Setting Facility Modifier None Typical Low $891.25 Median $3,090.30 Typical High $26,302.68 | Facility | None | $891.25 | $3,090.30 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $1,698.24 Median $5,370.32 Typical High $10,471.29 | Professional | None | $1,698.24 | $5,370.32 | $10,471.29 |
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 $446.68 Median $1,380.38 Typical High $3,388.44 | Professional | None | $446.68 | $1,380.38 | $3,388.44 |
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 $173.78 Median $281.84 Typical High $870.96 | Professional | 52 · Reduced service | $173.78 | $281.84 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $112.20 Typical High $354.81 | Professional | 53 · Discontinued | $69.18 | $112.20 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $416.87 Typical High $1,318.26 | Professional | 54 · Surgery only | $263.03 | $416.87 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $85.11 Typical High $263.03 | Professional | 55 · Aftercare only | $52.48 | $85.11 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $56.23 Typical High $173.78 | Professional | 56 · Pre-op care only | $34.67 | $56.23 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $389.05 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $245.47 | $389.05 | $1,230.27 |
Where Missouri sits
The same service costs 5.8 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· 31st of 51
$1,413
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.