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 $416.87 Median $5,623.41 Typical High $8,709.64 | Facility | None | $416.87 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $354.81 Typical High $467.74 | Professional | None | $288.40 | $354.81 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $660.69 | Professional | None | $380.19 | $501.19 | $660.69 |
BCBS Kansas City Setting Professional Modifier None Typical Low $346.74 Median $436.52 Typical High $588.84 | Professional | None | $346.74 | $436.52 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $2,238.72 Typical High $3,801.89 | Facility | None | $912.01 | $2,238.72 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $831.76 | Professional | None | $371.54 | $467.74 | $831.76 |
Medica Setting Facility Modifier None Typical Low $524.81 Median $2,398.83 Typical High $26,302.68 | Facility | None | $524.81 | $2,398.83 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $380.19 Median $2,691.53 Typical High $3,090.30 | Professional | None | $380.19 | $2,691.53 | $3,090.30 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $724.44 | Professional | None | $346.74 | $446.68 | $724.44 |
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 $144.54 Median $177.83 Typical High $199.53 | Professional | 52 · Reduced service | $144.54 | $177.83 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $70.79 Typical High $81.28 | Professional | 53 · Discontinued | $57.54 | $70.79 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $263.03 Typical High $302.00 | Professional | 54 · Surgery only | $213.80 | $263.03 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $52.48 Typical High $60.26 | Professional | 55 · Aftercare only | $42.66 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $35.48 Typical High $40.74 | Professional | 56 · Pre-op care only | $28.84 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $199.53 Median $245.47 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $199.53 | $245.47 | $281.84 |
Where Missouri sits
The same service costs 3.8 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· 24th of 51
$537
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.