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 $281.84 Median $3,162.28 Typical High $7,762.47 | Facility | None | $281.84 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $245.47 Typical High $281.84 | Professional | None | $165.96 | $245.47 | $281.84 |
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 $190.55 Median $239.88 Typical High $354.81 | Professional | None | $190.55 | $239.88 | $354.81 |
BCBS Kansas City Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $363.08 | Professional | None | $165.96 | $263.03 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $398.11 Typical High $1,659.59 | Facility | None | $288.40 | $398.11 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $257.04 Typical High $407.38 | Professional | None | $177.83 | $257.04 | $407.38 |
Medica Setting Facility Modifier None Typical Low $151.36 Median $660.69 Typical High $12,022.64 | Facility | None | $151.36 | $660.69 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $1,348.96 Typical High $2,398.83 | Professional | None | $323.59 | $1,348.96 | $2,398.83 |
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 $190.55 Median $302.00 Typical High $489.78 | Professional | None | $190.55 | $302.00 | $489.78 |
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 $83.18 Median $120.23 Typical High $141.25 | Professional | 52 · Reduced service | $83.18 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $47.86 Typical High $56.23 | Professional | 53 · Discontinued | $33.11 | $47.86 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $177.83 Typical High $213.80 | Professional | 54 · Surgery only | $125.89 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $36.31 Typical High $42.66 | Professional | 55 · Aftercare only | $25.12 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $23.99 Typical High $28.18 | Professional | 56 · Pre-op care only | $16.60 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $165.96 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $117.49 | $165.96 | $199.53 |
Where Missouri sits
The same service costs 4.2 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· 30th of 51
$269
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.