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 $3,235.94 Typical High $6,309.57 | Facility | None | $281.84 | $3,235.94 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $281.84 Typical High $346.74 | Professional | None | $208.93 | $281.84 | $346.74 |
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 $234.42 Median $281.84 Typical High $426.58 | Professional | None | $234.42 | $281.84 | $426.58 |
BCBS Kansas City Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $426.58 | Professional | None | $208.93 | $309.03 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $851.14 Typical High $2,187.76 | Facility | None | $588.84 | $851.14 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $295.12 Typical High $489.78 | Professional | None | $223.87 | $295.12 | $489.78 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $1,548.82 Typical High $16,218.10 | Facility | None | $380.19 | $1,548.82 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $398.11 Median $1,698.24 Typical High $2,290.87 | Professional | None | $398.11 | $1,698.24 | $2,290.87 |
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 $234.42 Median $363.08 Typical High $575.44 | Professional | None | $234.42 | $363.08 | $575.44 |
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 $104.71 Median $141.25 Typical High $165.96 | Professional | 52 · Reduced service | $104.71 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $56.23 Typical High $66.07 | Professional | 53 · Discontinued | $41.69 | $56.23 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $158.49 Median $213.80 Typical High $245.47 | Professional | 54 · Surgery only | $158.49 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $42.66 Typical High $48.98 | Professional | 55 · Aftercare only | $31.62 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $28.18 Typical High $33.11 | Professional | 56 · Pre-op care only | $20.89 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $147.91 Median $199.53 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $147.91 | $199.53 | $229.09 |
Where Missouri sits
The same service costs 4.3 times more in Alaska than in Utah. 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
$324
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.