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 $257.04 Median $3,162.28 Typical High $7,762.47 | Facility | None | $257.04 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $208.93 Typical High $257.04 | Professional | None | $109.65 | $208.93 | $257.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $1,621.81 Typical High $3,890.45 | Facility | None | $151.36 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $165.96 Typical High $275.42 | Professional | None | $107.15 | $165.96 | $275.42 |
BCBS Kansas City Setting Professional Modifier None Typical Low $114.82 Median $223.87 Typical High $309.03 | Professional | None | $114.82 | $223.87 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $190.55 Typical High $1,659.59 | Facility | None | $128.82 | $190.55 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $204.17 Typical High $346.74 | Professional | None | $112.20 | $204.17 | $346.74 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $660.69 Typical High $12,022.64 | Facility | None | $125.89 | $660.69 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $870.96 Typical High $1,698.24 | Professional | None | $275.42 | $870.96 | $1,698.24 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,137.96 | Facility | None | $123.03 | $602.56 | $2,137.96 |
United Setting Professional Modifier None Typical Low $131.83 Median $229.09 Typical High $407.38 | Professional | None | $131.83 | $229.09 | $407.38 |
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 $54.95 Median $97.72 Typical High $128.82 | Professional | 52 · Reduced service | $54.95 | $97.72 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $39.81 Typical High $51.29 | Professional | 53 · Discontinued | $21.88 | $39.81 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $147.91 Typical High $190.55 | Professional | 54 · Surgery only | $83.18 | $147.91 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $29.51 Typical High $38.90 | Professional | 55 · Aftercare only | $16.60 | $29.51 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $19.95 Typical High $25.70 | Professional | 56 · Pre-op care only | $10.96 | $19.95 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $138.04 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $77.62 | $138.04 | $177.83 |
Where Missouri sits
The same service costs 3.5 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· 23rd of 51
$219
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.