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 $229.09 Median $3,715.35 Typical High $6,309.57 | Facility | None | $229.09 | $3,715.35 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $234.42 Typical High $407.38 | Professional | None | $154.88 | $234.42 | $407.38 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $275.42 | Professional | None | $194.98 | $257.04 | $275.42 |
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 $186.21 Median $275.42 Typical High $416.87 | Professional | None | $186.21 | $275.42 | $416.87 |
BCBS Kansas City Setting Professional Modifier None Typical Low $186.21 Median $302.00 Typical High $338.84 | Professional | None | $186.21 | $302.00 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $524.81 Typical High $2,187.76 | Facility | None | $380.19 | $524.81 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $302.00 Typical High $478.63 | Professional | None | $204.17 | $302.00 | $478.63 |
Medica Setting Facility Modifier None Typical Low $346.74 Median $1,096.48 Typical High $16,218.10 | Facility | None | $346.74 | $1,096.48 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $1,584.89 Typical High $2,290.87 | Professional | None | $275.42 | $1,584.89 | $2,290.87 |
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 $190.55 Median $295.12 Typical High $512.86 | Professional | None | $190.55 | $295.12 | $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 $77.62 Median $114.82 Typical High $138.04 | Professional | 52 · Reduced service | $77.62 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $45.71 Typical High $54.95 | Professional | 53 · Discontinued | $30.90 | $45.71 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $169.82 Typical High $204.17 | Professional | 54 · Surgery only | $117.49 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $33.88 Typical High $41.69 | Professional | 55 · Aftercare only | $23.44 | $33.88 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $22.91 Typical High $27.54 | Professional | 56 · Pre-op care only | $15.49 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $158.49 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $109.65 | $158.49 | $190.55 |
Where Missouri sits
The same service costs 3.6 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· 31st of 51
$302
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.