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 $57.54 Median $1,698.24 Typical High $6,309.57 | Facility | None | $57.54 | $1,698.24 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $57.54 Typical High $102.33 | Professional | None | $39.81 | $57.54 | $102.33 |
Ambetter Setting Professional Modifier None Typical Low $46.77 Median $58.88 Typical High $89.13 | Professional | None | $46.77 | $58.88 | $89.13 |
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 $48.98 Median $58.88 Typical High $102.33 | Professional | None | $48.98 | $58.88 | $102.33 |
BCBS Kansas City Setting Professional Modifier None Typical Low $47.86 Median $64.57 Typical High $74.13 | Professional | None | $47.86 | $64.57 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $66.07 | Facility | None | $50.12 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $66.07 Typical High $123.03 | Professional | None | $53.70 | $66.07 | $123.03 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $245.47 Typical High $1,380.38 | Facility | None | $54.95 | $245.47 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $63.10 Median $416.87 Typical High $501.19 | Professional | None | $63.10 | $416.87 | $501.19 |
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 $46.77 Median $69.18 Typical High $123.03 | Professional | None | $46.77 | $69.18 | $123.03 |
7 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 $19.95 Median $24.55 Typical High $29.51 | Professional | 52 · Reduced service | $19.95 | $24.55 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $9.77 Typical High $11.75 | Professional | 53 · Discontinued | $7.94 | $9.77 | $11.75 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $37.15 Typical High $44.67 | Professional | 54 · Surgery only | $30.20 | $37.15 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $7.41 Typical High $8.91 | Professional | 55 · Aftercare only | $6.03 | $7.41 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $4.90 Typical High $5.89 | Professional | 56 · Pre-op care only | $3.98 | $4.90 | $5.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $28.18 Median $34.67 Typical High $41.69 | Professional | 78 · Unplanned return to OR | $28.18 | $34.67 | $41.69 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $46.77 Median $54.95 Typical High $87.10 | Professional | 59 · Distinct service | $46.77 | $54.95 | $87.10 |
Where Missouri sits
The same service costs 4.2 times more in Alaska than in Kentucky. 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· 30th of 51
$69.18
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.