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 $2,454.71 Median $5,623.41 Typical High $13,803.84 | Facility | None | $2,454.71 | $5,623.41 | $13,803.84 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $2,511.89 | Professional | None | $1,096.48 | $1,258.93 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $8,709.64 | Facility | None | $1,318.26 | $3,467.37 | $8,709.64 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,174.90 Median $1,479.11 Typical High $2,089.30 | Professional | None | $1,174.90 | $1,479.11 | $2,089.30 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $1,348.96 | Professional | None | $1,071.52 | $1,148.15 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $3,801.89 Typical High $5,248.07 | Facility | None | $1,202.26 | $3,801.89 | $5,248.07 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,230.27 Typical High $2,290.87 | Professional | None | $1,000.00 | $1,230.27 | $2,290.87 |
Medica Setting Facility Modifier None Typical Low $1,318.26 Median $4,570.88 Typical High $26,302.68 | Facility | None | $1,318.26 | $4,570.88 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $1,202.26 Median $2,951.21 Typical High $8,709.64 | Professional | None | $1,202.26 | $2,951.21 | $8,709.64 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,981.07 | $8,709.64 |
United Setting Professional Modifier None Typical Low $1,000.00 Median $1,621.81 Typical High $2,951.21 | Professional | None | $1,000.00 | $1,621.81 | $2,951.21 |
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 $549.54 Median $630.96 Typical High $660.69 | Professional | 52 · Reduced service | $549.54 | $630.96 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $251.19 Typical High $269.15 | Professional | 53 · Discontinued | $218.78 | $251.19 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $831.76 Median $933.25 Typical High $1,000.00 | Professional | 54 · Surgery only | $831.76 | $933.25 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $186.21 Typical High $199.53 | Professional | 55 · Aftercare only | $165.96 | $186.21 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $125.89 Typical High $134.90 | Professional | 56 · Pre-op care only | $109.65 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $870.96 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $776.25 | $870.96 | $933.25 |
Where Missouri sits
The same service costs 5.5 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· 25th of 51
$1,778
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.