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 $1,148.15 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,148.15 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $512.86 | Professional | None | $416.87 | $457.09 | $512.86 |
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 $354.81 Median $478.63 Typical High $691.83 | Professional | None | $354.81 | $478.63 | $691.83 |
BCBS Kansas City Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $660.69 | Professional | None | $426.58 | $467.74 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,659.59 Typical High $2,137.96 | Facility | None | $446.68 | $1,659.59 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $870.96 | Professional | None | $407.38 | $467.74 | $870.96 |
Medica Setting Facility Modifier None Typical Low $489.78 Median $1,819.70 Typical High $12,022.64 | Facility | None | $489.78 | $1,819.70 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $512.86 Median $3,388.44 Typical High $3,388.44 | Professional | None | $512.86 | $3,388.44 | $3,388.44 |
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 $416.87 Median $588.84 Typical High $1,047.13 | Professional | None | $416.87 | $588.84 | $1,047.13 |
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 $208.93 Median $213.80 Typical High $257.04 | Professional | 52 · Reduced service | $208.93 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $87.10 Typical High $102.33 | Professional | 53 · Discontinued | $85.11 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $323.59 Typical High $380.19 | Professional | 54 · Surgery only | $316.23 | $323.59 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $64.57 Typical High $75.86 | Professional | 55 · Aftercare only | $63.10 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $43.65 Typical High $51.29 | Professional | 56 · Pre-op care only | $41.69 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $302.00 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $295.12 | $302.00 | $354.81 |
Where Missouri sits
The same service costs 6.2 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· 29th of 51
$513
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.