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 $251.19 Median $3,162.28 Typical High $7,762.47 | Facility | None | $251.19 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $218.78 Typical High $398.11 | Professional | None | $165.96 | $218.78 | $398.11 |
Ambetter Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
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 $208.93 Median $263.03 Typical High $416.87 | Professional | None | $208.93 | $263.03 | $416.87 |
BCBS Kansas City Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $323.59 | Professional | None | $204.17 | $281.84 | $323.59 |
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 $229.09 Median $288.40 Typical High $478.63 | Professional | None | $229.09 | $288.40 | $478.63 |
Medica Setting Facility Modifier None Typical Low $338.84 Median $1,122.02 Typical High $12,022.64 | Facility | None | $338.84 | $1,122.02 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $1,698.24 Typical High $2,089.30 | Professional | None | $263.03 | $1,698.24 | $2,089.30 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $2,398.83 | Facility | None | $398.11 | $1,148.15 | $2,398.83 |
United Setting Professional Modifier None Typical Low $194.98 Median $288.40 Typical High $512.86 | Professional | None | $194.98 | $288.40 | $512.86 |
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 $83.18 Median $104.71 Typical High $125.89 | Professional | 52 · Reduced service | $83.18 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $41.69 Typical High $50.12 | Professional | 53 · Discontinued | $33.11 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $154.88 Typical High $186.21 | Professional | 54 · Surgery only | $123.03 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $30.90 Typical High $38.02 | Professional | 55 · Aftercare only | $24.55 | $30.90 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $20.89 Typical High $25.12 | Professional | 56 · Pre-op care only | $16.60 | $20.89 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $144.54 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $114.82 | $144.54 | $173.78 |
Where Missouri sits
The same service costs 3.9 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
$295
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.