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 $288.40 Median $3,162.28 Typical High $7,762.47 | Facility | None | $288.40 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $346.74 | Professional | None | $190.55 | $245.47 | $346.74 |
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 $208.93 Median $288.40 Typical High $457.09 | Professional | None | $208.93 | $288.40 | $457.09 |
BCBS Kansas City Setting Professional Modifier None Typical Low $194.98 Median $275.42 Typical High $380.19 | Professional | None | $194.98 | $275.42 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $851.14 Typical High $1,659.59 | Facility | None | $446.68 | $851.14 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $323.59 Typical High $616.60 | Professional | None | $194.98 | $323.59 | $616.60 |
Medica Setting Facility Modifier None Typical Low $371.54 Median $1,445.44 Typical High $12,022.64 | Facility | None | $371.54 | $1,445.44 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $354.81 Median $1,513.56 Typical High $1,995.26 | Professional | None | $354.81 | $1,513.56 | $1,995.26 |
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 $251.19 Median $416.87 Typical High $660.69 | Professional | None | $251.19 | $416.87 | $660.69 |
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 $91.20 Median $123.03 Typical High $144.54 | Professional | 52 · Reduced service | $91.20 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $50.12 Typical High $57.54 | Professional | 53 · Discontinued | $36.31 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $186.21 Typical High $213.80 | Professional | 54 · Surgery only | $138.04 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $37.15 Typical High $43.65 | Professional | 55 · Aftercare only | $27.54 | $37.15 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $24.55 Typical High $28.84 | Professional | 56 · Pre-op care only | $18.20 | $24.55 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $173.78 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $128.82 | $173.78 | $199.53 |
Where Missouri sits
The same service costs 4.3 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· 24th of 51
$363
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.