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 $190.55 Median $3,162.28 Typical High $7,762.47 | Facility | None | $190.55 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $165.96 Typical High $190.55 | Professional | None | $100.00 | $165.96 | $190.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $204.17 Median $3,467.37 Typical High $7,079.46 | Facility | None | $204.17 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $234.42 | Professional | None | $117.49 | $173.78 | $234.42 |
BCBS Kansas City Setting Professional Modifier None Typical Low $102.33 Median $181.97 Typical High $251.19 | Professional | None | $102.33 | $181.97 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $131.83 Typical High $186.21 | Facility | None | $58.88 | $131.83 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $169.82 Typical High $269.15 | Professional | None | $107.15 | $169.82 | $269.15 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $309.03 Typical High $1,288.25 | Facility | None | $54.95 | $309.03 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $812.83 Typical High $1,318.26 | Professional | None | $208.93 | $812.83 | $1,318.26 |
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 $120.23 Median $194.98 Typical High $338.84 | Professional | None | $120.23 | $194.98 | $338.84 |
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 $50.12 Median $81.28 Typical High $95.50 | Professional | 52 · Reduced service | $50.12 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $32.36 Typical High $38.02 | Professional | 53 · Discontinued | $20.42 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $123.03 Typical High $144.54 | Professional | 54 · Surgery only | $75.86 | $123.03 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $24.55 Typical High $28.84 | Professional | 55 · Aftercare only | $15.14 | $24.55 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $16.22 Typical High $19.05 | Professional | 56 · Pre-op care only | $10.00 | $16.22 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $114.82 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $70.79 | $114.82 | $134.90 |
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· 20th of 51
$191
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.