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 $169.82 Median $1,698.24 Typical High $6,309.57 | Facility | None | $169.82 | $1,698.24 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $173.78 Typical High $331.13 | Professional | None | $134.90 | $173.78 | $331.13 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $223.87 Typical High $295.12 | Professional | None | $162.18 | $223.87 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $1,621.81 Typical High $3,890.45 | Facility | None | $151.36 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $177.83 Typical High $309.03 | Professional | None | $144.54 | $177.83 | $309.03 |
BCBS Kansas City Setting Professional Modifier None Typical Low $173.78 Median $213.80 Typical High $251.19 | Professional | None | $173.78 | $213.80 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $186.21 Typical High $1,659.59 | Facility | None | $128.82 | $186.21 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $371.54 | Professional | None | $177.83 | $208.93 | $371.54 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $346.74 Typical High $2,570.40 | Facility | None | $54.95 | $346.74 | $2,570.40 |
Medica Setting Professional Modifier None Typical Low $186.21 Median $1,380.38 Typical High $1,584.89 | Professional | None | $186.21 | $1,380.38 | $1,584.89 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,137.96 | Facility | None | $123.03 | $602.56 | $2,137.96 |
United Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $398.11 | Professional | None | $147.91 | $223.87 | $398.11 |
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 $67.61 Median $79.43 Typical High $93.33 | Professional | 52 · Reduced service | $67.61 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $31.62 Typical High $38.02 | Professional | 53 · Discontinued | $26.92 | $31.62 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $120.23 Typical High $141.25 | Professional | 54 · Surgery only | $100.00 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $23.99 Typical High $28.18 | Professional | 55 · Aftercare only | $19.95 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $15.85 Typical High $19.05 | Professional | 56 · Pre-op care only | $13.49 | $15.85 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $112.20 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $93.33 | $112.20 | $131.83 |
Where Missouri sits
The same service costs 4.4 times more in Alaska than in Florida. 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· 36th of 51
$209
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.