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 $120.23 Median $2,754.23 Typical High $6,309.57 | Facility | None | $120.23 | $2,754.23 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $239.88 | Professional | None | $79.43 | $125.89 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $93.33 Median $97.72 Typical High $239.88 | Professional | None | $93.33 | $97.72 | $239.88 |
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 $107.15 Median $128.82 Typical High $213.80 | Professional | None | $107.15 | $128.82 | $213.80 |
BCBS Kansas City Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $177.83 | Professional | None | $100.00 | $154.88 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $158.49 Typical High $1,659.59 | Facility | None | $104.71 | $158.49 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $251.19 | Professional | None | $112.20 | $158.49 | $251.19 |
Medica Setting Facility Modifier None Typical Low $186.21 Median $1,096.48 Typical High $11,481.54 | Facility | None | $186.21 | $1,096.48 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $144.54 Median $812.83 Typical High $1,202.26 | Professional | None | $144.54 | $812.83 | $1,202.26 |
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 $95.50 Median $151.36 Typical High $263.03 | Professional | None | $95.50 | $151.36 | $263.03 |
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 $39.81 Median $58.88 Typical High $70.79 | Professional | 52 · Reduced service | $39.81 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $23.44 Typical High $28.18 | Professional | 53 · Discontinued | $16.22 | $23.44 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $89.13 Typical High $107.15 | Professional | 54 · Surgery only | $60.26 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $17.78 Typical High $21.38 | Professional | 55 · Aftercare only | $12.02 | $17.78 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $11.75 Typical High $14.13 | Professional | 56 · Pre-op care only | $7.94 | $11.75 | $14.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $83.18 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $56.23 | $83.18 | $100.00 |
Where Missouri sits
The same service costs 3.5 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
$151
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.