How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $562,341.33 Median $602,559.59 Typical High $933,254.30 | Facility | None | $562,341.33 | $602,559.59 | $933,254.30 |
Aetna Setting Professional Modifier None Typical Low $575,439.94 Median $602,559.59 Typical High $691,830.97 | Professional | None | $575,439.94 | $602,559.59 | $691,830.97 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.02 Median $0.03 Typical High $0.04 | Facility | None | $0.02 | $0.03 | $0.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $575,439.94 Median $676,082.98 Typical High $676,082.98 | Professional | None | $575,439.94 | $676,082.98 | $676,082.98 |
BCBS Kansas City Setting Professional Modifier None Typical Low $630,957.34 Median $630,957.34 Typical High $1,148,153.62 | Professional | None | $630,957.34 | $630,957.34 | $1,148,153.62 |
Cigna Setting Professional Modifier None Typical Low $549,540.87 Median $549,540.87 Typical High $676,082.98 | Professional | None | $549,540.87 | $549,540.87 | $676,082.98 |
Medica Setting Facility Modifier None Typical Low $501,187.23 Median $691,830.97 Typical High $933,254.30 | Facility | None | $501,187.23 | $691,830.97 | $933,254.30 |
Medica Setting Professional Modifier None Typical Low $977,237.22 Median $977,237.22 Typical High $977,237.22 | Professional | None | $977,237.22 | $977,237.22 | $977,237.22 |
United Setting Facility Modifier None Typical Low $575,439.94 Median $575,439.94 Typical High $575,439.94 | Facility | None | $575,439.94 | $575,439.94 | $575,439.94 |
United Setting Professional Modifier None Typical Low $562,341.33 Median $562,341.33 Typical High $660,693.45 | Professional | None | $562,341.33 | $562,341.33 | $660,693.45 |
4 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 $288,403.15 Median $295,120.92 Typical High $346,736.85 | Professional | 52 · Reduced service | $288,403.15 | $295,120.92 | $346,736.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114,815.36 Median $120,226.44 Typical High $138,038.43 | Professional | 53 · Discontinued | $114,815.36 | $120,226.44 | $138,038.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87,096.36 Median $89,125.09 Typical High $104,712.85 | Professional | 55 · Aftercare only | $87,096.36 | $89,125.09 | $104,712.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57,543.99 Median $60,255.96 Typical High $69,183.10 | Professional | 56 · Pre-op care only | $57,543.99 | $60,255.96 | $69,183.10 |
Where Missouri sits
The same service costs 1.7 times more in Texas than in Minnesota. 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· 8th of 51
$676,083
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.