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 $234.42 Median $2,511.89 Typical High $6,309.57 | Facility | None | $234.42 | $2,511.89 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $234.42 Typical High $426.58 | Professional | None | $144.54 | $234.42 | $426.58 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $263.03 Typical High $269.15 | Professional | None | $162.18 | $263.03 | $269.15 |
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 $194.98 Median $245.47 Typical High $426.58 | Professional | None | $194.98 | $245.47 | $426.58 |
BCBS Kansas City Setting Professional Modifier None Typical Low $177.83 Median $302.00 Typical High $338.84 | Professional | None | $177.83 | $302.00 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $213.80 Typical High $309.03 | Facility | None | $58.88 | $213.80 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $295.12 Typical High $467.74 | Professional | None | $194.98 | $295.12 | $467.74 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $363.08 Typical High $2,041.74 | Facility | None | $54.95 | $363.08 | $2,041.74 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $1,479.11 Typical High $2,344.23 | Professional | None | $263.03 | $1,479.11 | $2,344.23 |
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 $177.83 Median $288.40 Typical High $512.86 | Professional | None | $177.83 | $288.40 | $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 $72.44 Median $114.82 Typical High $141.25 | Professional | 52 · Reduced service | $72.44 | $114.82 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $46.77 Typical High $56.23 | Professional | 53 · Discontinued | $28.84 | $46.77 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $173.78 Typical High $208.93 | Professional | 54 · Surgery only | $109.65 | $173.78 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $34.67 Typical High $41.69 | Professional | 55 · Aftercare only | $21.88 | $34.67 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $23.44 Typical High $28.18 | Professional | 56 · Pre-op care only | $14.45 | $23.44 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $162.18 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $102.33 | $162.18 | $194.98 |
Where Missouri sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 35th of 51
$282
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.