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 $204.17 Median $3,162.28 Typical High $7,762.47 | Facility | None | $204.17 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $213.80 | Professional | None | $114.82 | $169.82 | $213.80 |
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 $100.00 Median $117.49 Typical High $181.97 | Professional | None | $100.00 | $117.49 | $181.97 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $151.36 Median $177.83 Typical High $275.42 | Professional | 50 · Both sides | $151.36 | $177.83 | $275.42 |
BCBS Kansas City Setting Professional Modifier None Typical Low $100.00 Median $169.82 Typical High $194.98 | Professional | None | $100.00 | $169.82 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,513.56 Typical High $1,819.70 | Facility | None | $446.68 | $1,513.56 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $169.82 Typical High $251.19 | Professional | None | $107.15 | $169.82 | $251.19 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $1,445.44 Typical High $12,022.64 | Facility | None | $204.17 | $1,445.44 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $158.49 Median $831.76 Typical High $1,318.26 | Professional | None | $158.49 | $831.76 | $1,318.26 |
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 $102.33 Median $162.18 Typical High $281.84 | Professional | None | $102.33 | $162.18 | $281.84 |
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 $57.54 Median $85.11 Typical High $107.15 | Professional | 52 · Reduced service | $57.54 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $33.88 Typical High $42.66 | Professional | 53 · Discontinued | $22.91 | $33.88 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $128.82 Typical High $158.49 | Professional | 54 · Surgery only | $85.11 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $25.70 Typical High $31.62 | Professional | 55 · Aftercare only | $16.98 | $25.70 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $16.98 Typical High $21.38 | Professional | 56 · Pre-op care only | $11.48 | $16.98 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $120.23 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $79.43 | $120.23 | $147.91 |
Where Missouri sits
The same service costs 4.8 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
$182
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.