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 $295.12 Median $3,235.94 Typical High $6,309.57 | Facility | None | $295.12 | $3,235.94 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $281.84 Typical High $501.19 | Professional | None | $204.17 | $281.84 | $501.19 |
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 $288.40 Median $363.08 Typical High $549.54 | Professional | None | $288.40 | $363.08 | $549.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $245.47 Median $380.19 Typical High $436.52 | Professional | None | $245.47 | $380.19 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $954.99 Typical High $2,187.76 | Facility | None | $602.56 | $954.99 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $630.96 | Professional | None | $288.40 | $398.11 | $630.96 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $1,548.82 Typical High $16,218.10 | Facility | None | $446.68 | $1,548.82 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $2,089.30 Typical High $2,884.03 | Professional | None | $363.08 | $2,089.30 | $2,884.03 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,235.94 | Facility | None | $562.34 | $1,513.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $251.19 Median $380.19 Typical High $660.69 | Professional | None | $251.19 | $380.19 | $660.69 |
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 $102.33 Median $141.25 Typical High $173.78 | Professional | 52 · Reduced service | $102.33 | $141.25 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $57.54 Typical High $69.18 | Professional | 53 · Discontinued | $40.74 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $213.80 Typical High $257.04 | Professional | 54 · Surgery only | $154.88 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $42.66 Typical High $51.29 | Professional | 55 · Aftercare only | $30.90 | $42.66 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $28.18 Typical High $34.67 | Professional | 56 · Pre-op care only | $20.42 | $28.18 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $199.53 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $144.54 | $199.53 | $239.88 |
Where Missouri sits
The same service costs 3.9 times more in Alaska than in Utah. 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· 28th of 51
$417
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.