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 $204.17 Median $2,570.40 Typical High $6,309.57 | Facility | None | $204.17 | $2,570.40 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $213.80 Typical High $398.11 | Professional | None | $141.25 | $213.80 | $398.11 |
Ambetter Setting Professional Modifier None Typical Low $120.23 Median $162.18 Typical High $181.97 | Professional | None | $120.23 | $162.18 | $181.97 |
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 $190.55 Median $251.19 Typical High $398.11 | Professional | None | $190.55 | $251.19 | $398.11 |
BCBS Kansas City Setting Professional Modifier None Typical Low $165.96 Median $269.15 Typical High $302.00 | Professional | None | $165.96 | $269.15 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $257.04 Typical High $1,659.59 | Facility | None | $173.78 | $257.04 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $275.42 Typical High $436.52 | Professional | None | $190.55 | $275.42 | $436.52 |
Medica Setting Facility Modifier None Typical Low $331.13 Median $1,096.48 Typical High $11,481.54 | Facility | None | $331.13 | $1,096.48 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $245.47 Median $1,445.44 Typical High $2,089.30 | Professional | None | $245.47 | $1,445.44 | $2,089.30 |
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 $173.78 Median $263.03 Typical High $467.74 | Professional | None | $173.78 | $263.03 | $467.74 |
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 $70.79 Median $102.33 Typical High $123.03 | Professional | 52 · Reduced service | $70.79 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $40.74 Typical High $48.98 | Professional | 53 · Discontinued | $28.18 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $154.88 Typical High $186.21 | Professional | 54 · Surgery only | $104.71 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $30.90 Typical High $37.15 | Professional | 55 · Aftercare only | $21.38 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $20.42 Typical High $24.55 | Professional | 56 · Pre-op care only | $14.13 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $144.54 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $97.72 | $144.54 | $173.78 |
Where Missouri sits
The same service costs 3.6 times more in Alaska than in Texas. 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· 29th of 51
$275
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.