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 $269.15 Median $3,162.28 Typical High $7,762.47 | Facility | None | $269.15 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $309.03 Typical High $562.34 | Professional | None | $186.21 | $309.03 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $245.47 Median $295.12 Typical High $467.74 | Professional | None | $245.47 | $295.12 | $467.74 |
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 $275.42 Median $380.19 Typical High $588.84 | Professional | None | $275.42 | $380.19 | $588.84 |
BCBS Kansas City Setting Professional Modifier None Typical Low $223.87 Median $407.38 Typical High $457.09 | Professional | None | $223.87 | $407.38 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $331.13 Typical High $2,691.53 | Facility | None | $218.78 | $331.13 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $389.05 Typical High $616.60 | Professional | None | $251.19 | $389.05 | $616.60 |
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 $380.19 Median $1,905.46 Typical High $3,162.28 | Professional | None | $380.19 | $1,905.46 | $3,162.28 |
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 $251.19 Median $416.87 Typical High $691.83 | Professional | None | $251.19 | $416.87 | $691.83 |
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 $93.33 Median $154.88 Typical High $190.55 | Professional | 52 · Reduced service | $93.33 | $154.88 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $63.10 Typical High $75.86 | Professional | 53 · Discontinued | $37.15 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $234.42 Typical High $281.84 | Professional | 54 · Surgery only | $141.25 | $234.42 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $46.77 Typical High $56.23 | Professional | 55 · Aftercare only | $28.18 | $46.77 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $30.90 Typical High $38.02 | Professional | 56 · Pre-op care only | $18.62 | $30.90 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $131.83 Median $218.78 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $131.83 | $218.78 | $263.03 |
Where Missouri sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 39th of 51
$398
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.