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 $436.52 Median $4,677.35 Typical High $7,762.47 | Facility | None | $436.52 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $501.19 | Professional | None | $281.84 | $426.58 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $263.03 Median $338.84 Typical High $537.03 | Professional | None | $263.03 | $338.84 | $537.03 |
BCBS Setting Professional Modifier None Typical Low $309.03 Median $501.19 Typical High $676.08 | Professional | None | $309.03 | $501.19 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $562.34 Typical High $2,691.53 | Facility | None | $398.11 | $562.34 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $398.11 Typical High $691.83 | Professional | None | $275.42 | $398.11 | $691.83 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,089.30 Typical High $6,165.95 | Facility | None | $54.95 | $2,089.30 | $6,165.95 |
Medica Setting Professional Modifier None Typical Low $512.86 Median $2,238.72 Typical High $3,467.37 | Professional | None | $512.86 | $2,238.72 | $3,467.37 |
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 $309.03 Median $478.63 Typical High $851.14 | Professional | None | $309.03 | $478.63 | $851.14 |
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 $141.25 Median $208.93 Typical High $251.19 | Professional | 52 · Reduced service | $141.25 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $83.18 Typical High $100.00 | Professional | 53 · Discontinued | $56.23 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $309.03 Typical High $380.19 | Professional | 54 · Surgery only | $208.93 | $309.03 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $63.10 Typical High $75.86 | Professional | 55 · Aftercare only | $41.69 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $41.69 Typical High $50.12 | Professional | 56 · Pre-op care only | $28.18 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $288.40 Typical High $354.81 | Professional | 78 · Unplanned return to OR | $194.98 | $288.40 | $354.81 |
Where Missouri sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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· 32nd of 51
$427
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.