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 $562.34 Median $3,162.28 Typical High $6,309.57 | Facility | None | $562.34 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $512.86 Typical High $588.84 | Professional | None | $331.13 | $512.86 | $588.84 |
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 $380.19 Median $501.19 Typical High $707.95 | Professional | None | $380.19 | $501.19 | $707.95 |
BCBS Kansas City Setting Professional Modifier None Typical Low $331.13 Median $537.03 Typical High $741.31 | Professional | None | $331.13 | $537.03 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,659.59 Typical High $2,137.96 | Facility | None | $446.68 | $1,659.59 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $501.19 Typical High $812.83 | Professional | None | $354.81 | $501.19 | $812.83 |
Medica Setting Facility Modifier None Typical Low $549.54 Median $1,548.82 Typical High $12,022.64 | Facility | None | $549.54 | $1,548.82 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $3,019.95 Typical High $4,073.80 | Professional | None | $645.65 | $3,019.95 | $4,073.80 |
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 $380.19 Median $602.56 Typical High $977.24 | Professional | None | $380.19 | $602.56 | $977.24 |
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 $165.96 Median $245.47 Typical High $295.12 | Professional | 52 · Reduced service | $165.96 | $245.47 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $97.72 Typical High $117.49 | Professional | 53 · Discontinued | $66.07 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $371.54 Typical High $446.68 | Professional | 54 · Surgery only | $245.47 | $371.54 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $74.13 Typical High $89.13 | Professional | 55 · Aftercare only | $50.12 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $48.98 Typical High $58.88 | Professional | 56 · Pre-op care only | $33.11 | $48.98 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $234.42 Median $346.74 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $234.42 | $346.74 | $416.87 |
Where Missouri sits
The same service costs 3.7 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
$537
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.