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 $371.54 Median $5,623.41 Typical High $10,715.19 | Facility | None | $371.54 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $316.23 Typical High $371.54 | Professional | None | $257.04 | $316.23 | $371.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $204.17 Median $3,467.37 Typical High $7,079.46 | Facility | None | $204.17 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $436.52 | Professional | None | $251.19 | $331.13 | $436.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $380.19 Median $501.19 Typical High $660.69 | Professional | 50 · Both sides | $380.19 | $501.19 | $660.69 |
BCBS Kansas City Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $354.81 | Professional | None | $213.80 | $309.03 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $275.42 Typical High $1,659.59 | Facility | None | $181.97 | $275.42 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $295.12 Typical High $512.86 | Professional | None | $239.88 | $295.12 | $512.86 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $776.25 Typical High $1,819.70 | Facility | None | $54.95 | $776.25 | $1,819.70 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $2,754.23 Typical High $3,311.31 | Professional | None | $309.03 | $2,754.23 | $3,311.31 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $2,238.72 | Facility | None | $398.11 | $1,148.15 | $2,238.72 |
United Setting Professional Modifier None Typical Low $257.04 Median $331.13 Typical High $512.86 | Professional | None | $257.04 | $331.13 | $512.86 |
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 $125.89 Median $151.36 Typical High $181.97 | Professional | 52 · Reduced service | $125.89 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $60.26 Typical High $74.13 | Professional | 53 · Discontinued | $51.29 | $60.26 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $229.09 Typical High $275.42 | Professional | 54 · Surgery only | $190.55 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $45.71 Typical High $54.95 | Professional | 55 · Aftercare only | $38.02 | $45.71 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $30.20 Typical High $37.15 | Professional | 56 · Pre-op care only | $25.70 | $30.20 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $213.80 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $177.83 | $213.80 | $257.04 |
Where Missouri sits
The same service costs 5.2 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· 23rd of 51
$372
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.