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 $245.47 Median $3,162.28 Typical High $6,309.57 | Facility | None | $245.47 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $199.53 Typical High $245.47 | Professional | None | $131.83 | $199.53 | $245.47 |
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 $158.49 Median $190.55 Typical High $275.42 | Professional | None | $158.49 | $190.55 | $275.42 |
BCBS Kansas City Setting Professional Modifier None Typical Low $141.25 Median $245.47 Typical High $309.03 | Professional | None | $141.25 | $245.47 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $630.96 Typical High $1,659.59 | Facility | None | $436.52 | $630.96 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $229.09 Typical High $371.54 | Professional | None | $128.82 | $229.09 | $371.54 |
Medica Setting Facility Modifier None Typical Low $346.74 Median $1,096.48 Typical High $12,022.64 | Facility | None | $346.74 | $1,096.48 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $281.84 Median $1,174.90 Typical High $1,778.28 | Professional | None | $281.84 | $1,174.90 | $1,778.28 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $2,398.83 | Facility | None | $398.11 | $1,148.15 | $2,398.83 |
United Setting Professional Modifier None Typical Low $165.96 Median $275.42 Typical High $446.68 | Professional | None | $165.96 | $275.42 | $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 $66.07 Median $100.00 Typical High $123.03 | Professional | 52 · Reduced service | $66.07 | $100.00 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $39.81 Typical High $48.98 | Professional | 53 · Discontinued | $26.30 | $39.81 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $151.36 Typical High $186.21 | Professional | 54 · Surgery only | $100.00 | $151.36 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $30.20 Typical High $37.15 | Professional | 55 · Aftercare only | $19.95 | $30.20 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $19.95 Typical High $24.55 | Professional | 56 · Pre-op care only | $13.18 | $19.95 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $141.25 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $93.33 | $141.25 | $173.78 |
Where Missouri sits
The same service costs 4.2 times more in Alaska than in Virginia. 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· 31st of 51
$257
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.