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 $112.20 Median $1,698.24 Typical High $6,309.57 | Facility | None | $112.20 | $1,698.24 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $144.54 Typical High $257.04 | Professional | None | $79.43 | $144.54 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $208.93 | Professional | None | $107.15 | $131.83 | $208.93 |
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 $117.49 Median $173.78 Typical High $251.19 | Professional | None | $117.49 | $173.78 | $251.19 |
BCBS Kansas City Setting Professional Modifier None Typical Low $95.50 Median $154.88 Typical High $173.78 | Professional | None | $95.50 | $154.88 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $151.36 Typical High $1,659.59 | Facility | None | $100.00 | $151.36 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $275.42 | Professional | None | $100.00 | $154.88 | $275.42 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $467.74 Typical High $11,481.54 | Facility | None | $125.89 | $467.74 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $158.49 Median $794.33 Typical High $1,202.26 | Professional | None | $158.49 | $794.33 | $1,202.26 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,137.96 | Facility | None | $123.03 | $602.56 | $2,137.96 |
United Setting Professional Modifier None Typical Low $95.50 Median $162.18 Typical High $288.40 | Professional | None | $95.50 | $162.18 | $288.40 |
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 $38.90 Median $61.66 Typical High $81.28 | Professional | 52 · Reduced service | $38.90 | $61.66 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $24.55 Typical High $32.36 | Professional | 53 · Discontinued | $15.49 | $24.55 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $91.20 Typical High $120.23 | Professional | 54 · Surgery only | $58.88 | $91.20 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $18.62 Typical High $24.55 | Professional | 55 · Aftercare only | $11.75 | $18.62 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $12.30 Typical High $16.22 | Professional | 56 · Pre-op care only | $7.76 | $12.30 | $16.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $54.95 Median $85.11 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $54.95 | $85.11 | $112.20 |
Where Missouri sits
The same service costs 3.2 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· 25th of 51
$186
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.