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 $112.20 Median $2,511.89 Typical High $6,309.57 | Facility | None | $112.20 | $2,511.89 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $120.23 Typical High $229.09 | Professional | None | $77.62 | $120.23 | $229.09 |
Ambetter Setting Professional Modifier None Typical Low $53.70 Median $95.50 Typical High $204.17 | Professional | None | $53.70 | $95.50 | $204.17 |
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 $97.72 Median $123.03 Typical High $218.78 | Professional | None | $97.72 | $123.03 | $218.78 |
BCBS Kansas City Setting Professional Modifier None Typical Low $95.50 Median $151.36 Typical High $169.82 | Professional | None | $95.50 | $151.36 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $162.18 Typical High $1,659.59 | Facility | None | $107.15 | $162.18 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $151.36 Typical High $239.88 | Professional | None | $107.15 | $151.36 | $239.88 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $489.78 Typical High $11,481.54 | Facility | None | $123.03 | $489.78 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $794.33 Typical High $1,174.90 | Professional | None | $134.90 | $794.33 | $1,174.90 |
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 $91.20 Median $144.54 Typical High $257.04 | Professional | None | $91.20 | $144.54 | $257.04 |
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 $38.90 Median $57.54 Typical High $69.18 | Professional | 52 · Reduced service | $38.90 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $22.91 Typical High $27.54 | Professional | 53 · Discontinued | $15.49 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $85.11 Typical High $104.71 | Professional | 54 · Surgery only | $58.88 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $16.98 Typical High $20.89 | Professional | 55 · Aftercare only | $11.75 | $16.98 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $11.48 Typical High $13.80 | Professional | 56 · Pre-op care only | $7.76 | $11.48 | $13.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $54.95 Median $79.43 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $54.95 | $79.43 | $97.72 |
Where Missouri sits
The same service costs 3.7 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· 33rd of 51
$148
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.