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 $562.34 Median $3,715.35 Typical High $7,762.47 | Facility | None | $562.34 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $489.78 Typical High $588.84 | Professional | None | $338.84 | $489.78 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $524.81 Typical High $794.33 | Professional | None | $371.54 | $524.81 | $794.33 |
BCBS Kansas City Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $588.84 | Professional | None | $338.84 | $512.86 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $2,187.76 | Facility | None | $602.56 | $1,819.70 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $512.86 Typical High $831.76 | Professional | None | $363.08 | $512.86 | $831.76 |
Medica Setting Facility Modifier None Typical Low $549.54 Median $1,548.82 Typical High $16,218.10 | Facility | None | $549.54 | $1,548.82 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $588.84 Median $3,019.95 Typical High $3,981.07 | Professional | None | $588.84 | $3,019.95 | $3,981.07 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,235.94 | Facility | None | $562.34 | $1,513.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $346.74 Median $645.65 Typical High $1,174.90 | Professional | None | $346.74 | $645.65 | $1,174.90 |
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 $169.82 Median $223.87 Typical High $281.84 | Professional | 52 · Reduced service | $169.82 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $91.20 Typical High $112.20 | Professional | 53 · Discontinued | $67.61 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $338.84 Typical High $426.58 | Professional | 54 · Surgery only | $257.04 | $338.84 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $67.61 Typical High $85.11 | Professional | 55 · Aftercare only | $51.29 | $67.61 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $44.67 Typical High $56.23 | Professional | 56 · Pre-op care only | $33.88 | $44.67 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $239.88 Median $316.23 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $239.88 | $316.23 | $398.11 |
Where Missouri sits
The same service costs 4.4 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· 33rd of 51
$562
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.