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 $251.19 Median $3,162.28 Typical High $7,762.47 | Facility | None | $251.19 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $213.80 Typical High $251.19 | Professional | None | $131.83 | $213.80 | $251.19 |
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 $158.49 Median $208.93 Typical High $302.00 | Professional | None | $158.49 | $208.93 | $302.00 |
BCBS Kansas City Setting Professional Modifier None Typical Low $131.83 Median $234.42 Typical High $309.03 | Professional | None | $131.83 | $234.42 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $245.47 Typical High $1,659.59 | Facility | None | $162.18 | $245.47 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $363.08 | Professional | None | $138.04 | $218.78 | $363.08 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,000.00 Typical High $2,630.27 | Facility | None | $54.95 | $1,000.00 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $1,047.13 Typical High $1,698.24 | Professional | None | $302.00 | $1,047.13 | $1,698.24 |
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 $162.18 Median $269.15 Typical High $446.68 | Professional | None | $162.18 | $269.15 | $446.68 |
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 $66.07 Median $107.15 Typical High $125.89 | Professional | 52 · Reduced service | $66.07 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $42.66 Typical High $50.12 | Professional | 53 · Discontinued | $26.30 | $42.66 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $162.18 Typical High $186.21 | Professional | 54 · Surgery only | $100.00 | $162.18 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $32.36 Typical High $37.15 | Professional | 55 · Aftercare only | $19.95 | $32.36 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $21.38 Typical High $25.12 | Professional | 56 · Pre-op care only | $13.18 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $151.36 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $93.33 | $151.36 | $173.78 |
Where Missouri sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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
$234
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.