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 $1,548.82 Median $3,981.07 Typical High $7,762.47 | Facility | None | $1,548.82 | $3,981.07 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $467.74 Typical High $1,548.82 | Professional | None | $446.68 | $467.74 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $524.81 Typical High $891.25 | Professional | None | $380.19 | $524.81 | $891.25 |
BCBS Kansas City Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $758.58 | Professional | None | $478.63 | $537.03 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,584.89 Typical High $2,187.76 | Facility | None | $602.56 | $1,584.89 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $1,148.15 | Professional | None | $467.74 | $562.34 | $1,148.15 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $2,754.23 Typical High $16,218.10 | Facility | None | $724.44 | $2,754.23 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $426.58 Median $1,122.02 Typical High $3,630.78 | Professional | None | $426.58 | $1,122.02 | $3,630.78 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $426.58 Median $562.34 Typical High $1,148.15 | Professional | None | $426.58 | $562.34 | $1,148.15 |
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 $218.78 Median $234.42 Typical High $251.19 | Professional | 52 · Reduced service | $218.78 | $234.42 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $95.50 Typical High $102.33 | Professional | 53 · Discontinued | $89.13 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $331.13 Median $354.81 Typical High $380.19 | Professional | 54 · Surgery only | $331.13 | $354.81 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $70.79 Typical High $75.86 | Professional | 55 · Aftercare only | $66.07 | $70.79 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $46.77 Typical High $50.12 | Professional | 56 · Pre-op care only | $44.67 | $46.77 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $331.13 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $309.03 | $331.13 | $354.81 |
Where Missouri sits
The same service costs 5.5 times more in Alaska than in Utah. 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
$676
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.