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 $288.40 Median $4,677.35 Typical High $7,762.47 | Facility | None | $288.40 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $346.74 | Professional | None | $169.82 | $251.19 | $346.74 |
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 $109.65 Median $204.17 Typical High $338.84 | Professional | None | $109.65 | $204.17 | $338.84 |
BCBS Kansas City Setting Professional Modifier None Typical Low $199.53 Median $346.74 Typical High $478.63 | Professional | None | $199.53 | $346.74 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $436.52 Typical High $2,691.53 | Facility | None | $288.40 | $436.52 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $275.42 Typical High $457.09 | Professional | None | $165.96 | $275.42 | $457.09 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $676.08 Typical High $1,949.84 | Facility | None | $54.95 | $676.08 | $1,949.84 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $1,380.38 Typical High $2,290.87 | Professional | None | $295.12 | $1,380.38 | $2,290.87 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $2,398.83 | Facility | None | $398.11 | $1,148.15 | $2,398.83 |
United Setting Professional Modifier None Typical Low $169.82 Median $288.40 Typical High $562.34 | Professional | None | $169.82 | $288.40 | $562.34 |
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 $85.11 Median $123.03 Typical High $169.82 | Professional | 52 · Reduced service | $85.11 | $123.03 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $50.12 Typical High $67.61 | Professional | 53 · Discontinued | $33.88 | $50.12 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $186.21 Typical High $251.19 | Professional | 54 · Surgery only | $128.82 | $186.21 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $37.15 Typical High $50.12 | Professional | 55 · Aftercare only | $25.70 | $37.15 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $25.12 Typical High $33.88 | Professional | 56 · Pre-op care only | $16.98 | $25.12 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $173.78 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $120.23 | $173.78 | $234.42 |
Where Missouri sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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
$282
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.