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 $512.86 Median $4,897.79 Typical High $7,762.47 | Facility | None | $512.86 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $436.52 Typical High $478.63 | Professional | None | $398.11 | $436.52 | $478.63 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $10,471.29 | Facility | None | $1,412.54 | $3,801.89 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $478.63 Typical High $660.69 | Professional | None | $199.53 | $478.63 | $660.69 |
BCBS Kansas City Setting Professional Modifier None Typical Low $416.87 Median $457.09 Typical High $645.65 | Professional | None | $416.87 | $457.09 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,691.53 | Facility | None | $489.78 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $870.96 | Professional | None | $407.38 | $467.74 | $870.96 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,000.00 Typical High $3,090.30 | Facility | None | $54.95 | $1,000.00 | $3,090.30 |
Medica Setting Professional Modifier None Typical Low $524.81 Median $3,090.30 Typical High $3,090.30 | Professional | None | $524.81 | $3,090.30 | $3,090.30 |
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 $407.38 Median $660.69 Typical High $1,047.13 | Professional | None | $407.38 | $660.69 | $1,047.13 |
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 $199.53 Median $213.80 Typical High $239.88 | Professional | 52 · Reduced service | $199.53 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $85.11 Typical High $97.72 | Professional | 53 · Discontinued | $79.43 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $302.00 Median $323.59 Typical High $363.08 | Professional | 54 · Surgery only | $302.00 | $323.59 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $64.57 Typical High $72.44 | Professional | 55 · Aftercare only | $60.26 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $42.66 Typical High $48.98 | Professional | 56 · Pre-op care only | $39.81 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $281.84 Median $302.00 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $281.84 | $302.00 | $338.84 |
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· 29th of 51
$513
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.