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 $181.97 Median $2,570.40 Typical High $6,309.57 | Facility | None | $181.97 | $2,570.40 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $354.81 | Professional | None | $120.23 | $181.97 | $354.81 |
Ambetter Setting Professional Modifier None Typical Low $104.71 Median $229.09 Typical High $346.74 | Professional | None | $104.71 | $229.09 | $346.74 |
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 $147.91 Median $194.98 Typical High $302.00 | Professional | None | $147.91 | $194.98 | $302.00 |
BCBS Kansas City Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $251.19 | Professional | None | $154.88 | $223.87 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $954.99 Typical High $1,659.59 | Facility | None | $446.68 | $954.99 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $223.87 Typical High $363.08 | Professional | None | $165.96 | $223.87 | $363.08 |
Medica Setting Facility Modifier None Typical Low $257.04 Median $1,445.44 Typical High $12,022.64 | Facility | None | $257.04 | $1,445.44 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $1,230.27 Typical High $1,659.59 | Professional | None | $199.53 | $1,230.27 | $1,659.59 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,235.94 | Facility | None | $562.34 | $1,513.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $141.25 Median $213.80 Typical High $380.19 | Professional | None | $141.25 | $213.80 | $380.19 |
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 $60.26 Median $83.18 Typical High $100.00 | Professional | 52 · Reduced service | $60.26 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $33.11 Typical High $39.81 | Professional | 53 · Discontinued | $23.99 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $123.03 Typical High $147.91 | Professional | 54 · Surgery only | $91.20 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $24.55 Typical High $29.51 | Professional | 55 · Aftercare only | $18.20 | $24.55 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $16.60 Typical High $19.95 | Professional | 56 · Pre-op care only | $12.02 | $16.60 | $19.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $114.82 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $85.11 | $114.82 | $138.04 |
Where Missouri sits
The same service costs 4.6 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· 30th of 51
$224
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.