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 $338.84 Median $3,715.35 Typical High $6,309.57 | Facility | None | $338.84 | $3,715.35 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $316.23 Typical High $562.34 | Professional | None | $229.09 | $316.23 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $269.15 Median $426.58 Typical High $426.58 | Professional | None | $269.15 | $426.58 | $426.58 |
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 $295.12 Median $354.81 Typical High $575.44 | Professional | None | $295.12 | $354.81 | $575.44 |
BCBS Kansas City Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $457.09 | Professional | None | $288.40 | $389.05 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,584.89 Typical High $2,187.76 | Facility | None | $602.56 | $1,584.89 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $389.05 Typical High $676.08 | Professional | None | $316.23 | $389.05 | $676.08 |
Medica Setting Facility Modifier None Typical Low $467.74 Median $2,398.83 Typical High $16,218.10 | Facility | None | $467.74 | $2,398.83 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $354.81 Median $2,344.23 Typical High $2,884.03 | Professional | None | $354.81 | $2,344.23 | $2,884.03 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $275.42 Median $407.38 Typical High $724.44 | Professional | None | $275.42 | $407.38 | $724.44 |
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 $114.82 Median $141.25 Typical High $169.82 | Professional | 52 · Reduced service | $114.82 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $56.23 Typical High $67.61 | Professional | 53 · Discontinued | $46.77 | $56.23 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $208.93 Typical High $257.04 | Professional | 54 · Surgery only | $173.78 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $41.69 Typical High $51.29 | Professional | 55 · Aftercare only | $34.67 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $28.18 Typical High $33.88 | Professional | 56 · Pre-op care only | $22.91 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $194.98 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $162.18 | $194.98 | $239.88 |
Where Missouri sits
The same service costs 4.5 times more in Alaska than in New Jersey. 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· 31st of 51
$407
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.