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 $263.03 Median $3,715.35 Typical High $6,309.57 | Facility | None | $263.03 | $3,715.35 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $213.80 Typical High $263.03 | Professional | None | $158.49 | $213.80 | $263.03 |
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 $190.55 Median $234.42 Typical High $323.59 | Professional | None | $190.55 | $234.42 | $323.59 |
BCBS Kansas City Setting Professional Modifier None Typical Low $190.55 Median $269.15 Typical High $338.84 | Professional | None | $190.55 | $269.15 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $645.65 Typical High $2,187.76 | Facility | None | $478.63 | $645.65 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $239.88 Typical High $416.87 | Professional | None | $158.49 | $239.88 | $416.87 |
Medica Setting Facility Modifier None Typical Low $331.13 Median $1,096.48 Typical High $16,218.10 | Facility | None | $331.13 | $1,096.48 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $281.84 Median $1,513.56 Typical High $1,905.46 | Professional | None | $281.84 | $1,513.56 | $1,905.46 |
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 $186.21 Median $323.59 Typical High $478.63 | Professional | None | $186.21 | $323.59 | $478.63 |
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 $79.43 Median $107.15 Typical High $131.83 | Professional | 52 · Reduced service | $79.43 | $107.15 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $42.66 Typical High $52.48 | Professional | 53 · Discontinued | $31.62 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $158.49 Typical High $194.98 | Professional | 54 · Surgery only | $120.23 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $31.62 Typical High $38.90 | Professional | 55 · Aftercare only | $23.99 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $21.38 Typical High $26.30 | Professional | 56 · Pre-op care only | $15.85 | $21.38 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $147.91 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $112.20 | $147.91 | $181.97 |
Where Missouri sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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
$282
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.