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 $2,290.87 Median $5,754.40 Typical High $10,715.19 | Facility | None | $2,290.87 | $5,754.40 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $588.84 Typical High $2,511.89 | Professional | None | $501.19 | $588.84 | $2,511.89 |
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 $512.86 Median $630.96 Typical High $977.24 | Professional | None | $512.86 | $630.96 | $977.24 |
BCBS Kansas City Setting Professional Modifier None Typical Low $478.63 Median $512.86 Typical High $691.83 | Professional | None | $478.63 | $512.86 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $758.58 Median $2,884.03 Typical High $3,388.44 | Facility | None | $758.58 | $2,884.03 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $602.56 Typical High $1,096.48 | Professional | None | $457.09 | $602.56 | $1,096.48 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $3,715.35 Typical High $26,302.68 | Facility | None | $724.44 | $3,715.35 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $630.96 Median $1,288.25 Typical High $7,413.10 | Professional | None | $630.96 | $1,288.25 | $7,413.10 |
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 $831.76 Typical High $1,445.44 | Professional | None | $524.81 | $831.76 | $1,445.44 |
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 $251.19 Median $288.40 Typical High $309.03 | Professional | 52 · Reduced service | $251.19 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $117.49 Typical High $125.89 | Professional | 53 · Discontinued | $100.00 | $117.49 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $436.52 Typical High $467.74 | Professional | 54 · Surgery only | $380.19 | $436.52 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $87.10 Typical High $93.33 | Professional | 55 · Aftercare only | $75.86 | $87.10 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $58.88 Typical High $63.10 | Professional | 56 · Pre-op care only | $50.12 | $58.88 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $407.38 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $354.81 | $407.38 | $436.52 |
Where Missouri sits
The same service costs 5.4 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· 32nd of 51
$794
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.