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 $257.04 Median $3,162.28 Typical High $7,762.47 | Facility | None | $257.04 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $218.78 Typical High $269.15 | Professional | None | $125.89 | $218.78 | $269.15 |
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 $128.82 Median $194.98 Typical High $309.03 | Professional | None | $128.82 | $194.98 | $309.03 |
BCBS Kansas City Setting Professional Modifier None Typical Low $138.04 Median $263.03 Typical High $354.81 | Professional | None | $138.04 | $263.03 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $295.12 Typical High $1,659.59 | Facility | None | $194.98 | $295.12 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $223.87 Typical High $380.19 | Professional | None | $134.90 | $223.87 | $380.19 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $331.13 Typical High $1,288.25 | Facility | None | $54.95 | $331.13 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $281.84 Median $1,023.29 Typical High $1,778.28 | Professional | None | $281.84 | $1,023.29 | $1,778.28 |
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 $151.36 Median $257.04 Typical High $446.68 | Professional | None | $151.36 | $257.04 | $446.68 |
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 $63.10 Median $109.65 Typical High $128.82 | Professional | 52 · Reduced service | $63.10 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $43.65 Typical High $51.29 | Professional | 53 · Discontinued | $25.12 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $165.96 Typical High $190.55 | Professional | 54 · Surgery only | $95.50 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $33.11 Typical High $38.02 | Professional | 55 · Aftercare only | $19.05 | $33.11 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $21.88 Typical High $25.70 | Professional | 56 · Pre-op care only | $12.59 | $21.88 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $154.88 Typical High $177.83 | Professional | 78 · Unplanned return to OR | $89.13 | $154.88 | $177.83 |
Where Missouri sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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
$234
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.