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 $257.04 Median $3,162.28 Typical High $7,762.47 | Facility | None | $257.04 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $295.12 Typical High $524.81 | Professional | None | $181.97 | $295.12 | $524.81 |
Ambetter Setting Professional Modifier None Typical Low $162.18 Median $275.42 Typical High $457.09 | Professional | None | $162.18 | $275.42 | $457.09 |
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 $263.03 Median $338.84 Typical High $524.81 | Professional | None | $263.03 | $338.84 | $524.81 |
BCBS Kansas City Setting Professional Modifier None Typical Low $213.80 Median $380.19 Typical High $426.58 | Professional | None | $213.80 | $380.19 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $562.34 Typical High $2,691.53 | Facility | None | $398.11 | $562.34 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $371.54 Typical High $575.44 | Professional | None | $239.88 | $371.54 | $575.44 |
Medica Setting Facility Modifier None Typical Low $151.36 Median $660.69 Typical High $26,302.68 | Facility | None | $151.36 | $660.69 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $1,819.70 Typical High $2,951.21 | Professional | None | $363.08 | $1,819.70 | $2,951.21 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,454.71 | Facility | None | $123.03 | $602.56 | $2,454.71 |
United Setting Professional Modifier None Typical Low $234.42 Median $371.54 Typical High $645.65 | Professional | None | $234.42 | $371.54 | $645.65 |
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 $91.20 Median $144.54 Typical High $177.83 | Professional | 52 · Reduced service | $91.20 | $144.54 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $58.88 Typical High $70.79 | Professional | 53 · Discontinued | $36.31 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $218.78 Typical High $263.03 | Professional | 54 · Surgery only | $134.90 | $218.78 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $43.65 Typical High $52.48 | Professional | 55 · Aftercare only | $26.92 | $43.65 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $29.51 Typical High $35.48 | Professional | 56 · Pre-op care only | $18.20 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $204.17 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $125.89 | $204.17 | $245.47 |
Where Missouri sits
The same service costs 3.3 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· 36th of 51
$372
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.