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 $467.74 Median $3,715.35 Typical High $7,762.47 | Facility | None | $467.74 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $398.11 Typical High $467.74 | Professional | None | $363.08 | $398.11 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,380.38 Median $3,801.89 Typical High $9,549.93 | Facility | None | $1,380.38 | $3,801.89 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $338.84 Median $426.58 Typical High $588.84 | Professional | None | $338.84 | $426.58 | $588.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $512.86 Median $645.65 Typical High $891.25 | Professional | 50 · Both sides | $512.86 | $645.65 | $891.25 |
BCBS Kansas City Setting Professional Modifier None Typical Low $309.03 Median $380.19 Typical High $478.63 | Professional | None | $309.03 | $380.19 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $436.52 Typical High $2,187.76 | Facility | None | $295.12 | $436.52 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $371.54 Typical High $660.69 | Professional | None | $323.59 | $371.54 | $660.69 |
Medica Setting Facility Modifier None Typical Low $407.38 Median $1,096.48 Typical High $16,218.10 | Facility | None | $407.38 | $1,096.48 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $2,630.27 Typical High $2,884.03 | Professional | None | $363.08 | $2,630.27 | $2,884.03 |
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 $316.23 Median $407.38 Typical High $660.69 | Professional | None | $316.23 | $407.38 | $660.69 |
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 $181.97 Median $199.53 Typical High $234.42 | Professional | 52 · Reduced service | $181.97 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $79.43 Typical High $93.33 | Professional | 53 · Discontinued | $72.44 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $269.15 Median $302.00 Typical High $346.74 | Professional | 54 · Surgery only | $269.15 | $302.00 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $60.26 Typical High $69.18 | Professional | 55 · Aftercare only | $54.95 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $39.81 Typical High $46.77 | Professional | 56 · Pre-op care only | $36.31 | $39.81 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $251.19 Median $281.84 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $251.19 | $281.84 | $323.59 |
Where Missouri sits
The same service costs 5.6 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· 26th of 51
$468
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.