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 $1,548.82 Median $4,677.35 Typical High $7,762.47 | Facility | None | $1,548.82 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $467.74 Typical High $1,548.82 | Professional | None | $380.19 | $467.74 | $1,548.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,801.89 Typical High $11,481.54 | Facility | None | $1,318.26 | $3,801.89 | $11,481.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $467.74 Median $602.56 Typical High $912.01 | Professional | None | $467.74 | $602.56 | $912.01 |
BCBS Kansas City Setting Professional Modifier None Typical Low $426.58 Median $467.74 Typical High $660.69 | Professional | None | $426.58 | $467.74 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $3,388.44 | Facility | None | $645.65 | $2,290.87 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $562.34 Typical High $1,148.15 | Professional | None | $467.74 | $562.34 | $1,148.15 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $2,754.23 Typical High $16,218.10 | Facility | None | $724.44 | $2,754.23 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $1,202.26 Typical High $3,715.35 | Professional | None | $489.78 | $1,202.26 | $3,715.35 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $16,595.87 | Facility | None | $1,000.00 | $2,818.38 | $16,595.87 |
United Setting Professional Modifier None Typical Low $467.74 Median $645.65 Typical High $1,288.25 | Professional | None | $467.74 | $645.65 | $1,288.25 |
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 $190.55 Median $234.42 Typical High $245.47 | Professional | 52 · Reduced service | $190.55 | $234.42 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $93.33 Typical High $97.72 | Professional | 53 · Discontinued | $75.86 | $93.33 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $354.81 Typical High $371.54 | Professional | 54 · Surgery only | $281.84 | $354.81 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $70.79 Typical High $74.13 | Professional | 55 · Aftercare only | $57.54 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $46.77 Typical High $48.98 | Professional | 56 · Pre-op care only | $38.02 | $46.77 | $48.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $263.03 Median $331.13 Typical High $346.74 | Professional | 78 · Unplanned return to OR | $263.03 | $331.13 | $346.74 |
Where Missouri sits
The same service costs 6.5 times more in Alaska than in Texas. 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
$661
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.