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 $616.60 Median $5,623.41 Typical High $8,709.64 | Facility | None | $616.60 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $645.65 | Professional | None | $512.86 | $575.44 | $645.65 |
Ambetter Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $812.83 | Professional | None | $575.44 | $575.44 | $812.83 |
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 $524.81 Median $831.76 Typical High $1,071.52 | Professional | None | $524.81 | $831.76 | $1,071.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $776.25 Median $1,230.27 Typical High $1,621.81 | Professional | 50 · Both sides | $776.25 | $1,230.27 | $1,621.81 |
BCBS Kansas City Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $691.83 | Professional | None | $436.52 | $512.86 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $407.38 Typical High $1,659.59 | Facility | None | $288.40 | $407.38 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $501.19 Typical High $954.99 | Professional | None | $457.09 | $501.19 | $954.99 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $933.25 Typical High $3,890.45 | Facility | None | $54.95 | $933.25 | $3,890.45 |
Medica Setting Professional Modifier None Typical Low $524.81 Median $3,715.35 Typical High $3,801.89 | Professional | None | $524.81 | $3,715.35 | $3,801.89 |
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 $457.09 Median $588.84 Typical High $933.25 | Professional | None | $457.09 | $588.84 | $933.25 |
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 $257.04 Median $275.42 Typical High $309.03 | Professional | 52 · Reduced service | $257.04 | $275.42 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $109.65 Typical High $123.03 | Professional | 53 · Discontinued | $102.33 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $416.87 Typical High $457.09 | Professional | 54 · Surgery only | $380.19 | $416.87 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $83.18 Typical High $93.33 | Professional | 55 · Aftercare only | $75.86 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $54.95 Typical High $61.66 | Professional | 56 · Pre-op care only | $51.29 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $389.05 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $354.81 | $389.05 | $426.58 |
Where Missouri sits
The same service costs 6.2 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· 24th of 51
$692
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.