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 $316.23 Median $4,570.88 Typical High $8,317.64 | Facility | None | $316.23 | $4,570.88 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $302.00 Typical High $416.87 | Professional | None | $263.03 | $302.00 | $416.87 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $398.11 Typical High $398.11 | Professional | None | $281.84 | $398.11 | $398.11 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,388.44 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,388.44 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $354.81 Typical High $512.86 | Professional | None | $288.40 | $354.81 | $512.86 |
BCBS Kansas City Setting Professional Modifier None Typical Low $263.03 Median $288.40 Typical High $416.87 | Professional | None | $263.03 | $288.40 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,951.21 Typical High $4,677.35 | Facility | None | $645.65 | $2,951.21 | $4,677.35 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $575.44 | Professional | None | $275.42 | $302.00 | $575.44 |
Medica Setting Facility Modifier None Typical Low $645.65 Median $2,754.23 Typical High $26,302.68 | Facility | None | $645.65 | $2,754.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $346.74 Median $2,630.27 Typical High $2,630.27 | Professional | None | $346.74 | $2,630.27 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $6,456.54 | Facility | None | $1,000.00 | $2,818.38 | $6,456.54 |
United Setting Professional Modifier None Typical Low $269.15 Median $407.38 Typical High $691.83 | Professional | None | $269.15 | $407.38 | $691.83 |
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 $134.90 Median $141.25 Typical High $165.96 | Professional | 52 · Reduced service | $134.90 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $57.54 Typical High $66.07 | Professional | 53 · Discontinued | $53.70 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $213.80 Typical High $245.47 | Professional | 54 · Surgery only | $204.17 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $42.66 Typical High $48.98 | Professional | 55 · Aftercare only | $40.74 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $28.18 Typical High $33.11 | Professional | 56 · Pre-op care only | $26.92 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $199.53 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $190.55 | $199.53 | $229.09 |
Where Missouri sits
The same service costs 5.5 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· 23rd of 51
$407
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.