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 $190.55 Median $3,162.28 Typical High $7,762.47 | Facility | None | $190.55 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $190.55 | Professional | None | $134.90 | $162.18 | $190.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $275.42 | Professional | None | $134.90 | $169.82 | $275.42 |
BCBS Kansas City Setting Professional Modifier None Typical Low $151.36 Median $190.55 Typical High $257.04 | Professional | None | $151.36 | $190.55 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $851.14 Typical High $1,659.59 | Facility | None | $446.68 | $851.14 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $204.17 Typical High $398.11 | Professional | None | $154.88 | $204.17 | $398.11 |
Medica Setting Facility Modifier None Typical Low $263.03 Median $1,445.44 Typical High $12,022.64 | Facility | None | $263.03 | $1,445.44 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $1,174.90 Typical High $1,380.38 | Professional | None | $173.78 | $1,174.90 | $1,380.38 |
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 $151.36 Median $194.98 Typical High $316.23 | Professional | None | $151.36 | $194.98 | $316.23 |
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 $67.61 Median $79.43 Typical High $93.33 | Professional | 52 · Reduced service | $67.61 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $32.36 Typical High $38.02 | Professional | 53 · Discontinued | $27.54 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $120.23 Typical High $141.25 | Professional | 54 · Surgery only | $102.33 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $23.99 Typical High $28.18 | Professional | 55 · Aftercare only | $20.42 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $16.22 Typical High $19.05 | Professional | 56 · Pre-op care only | $13.49 | $16.22 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $112.20 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $95.50 | $112.20 | $131.83 |
Where Missouri sits
The same service costs 4.6 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· 35th of 51
$214
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.