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 $74.13 Median $1,819.70 Typical High $6,309.57 | Facility | None | $74.13 | $1,819.70 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $83.18 Typical High $147.91 | Professional | None | $48.98 | $83.18 | $147.91 |
Ambetter Setting Professional Modifier None Typical Low $69.18 Median $91.20 Typical High $144.54 | Professional | None | $69.18 | $91.20 | $144.54 |
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 $58.88 Median $77.62 Typical High $162.18 | Professional | None | $58.88 | $77.62 | $162.18 |
BCBS Kansas City Setting Professional Modifier None Typical Low $63.10 Median $104.71 Typical High $120.23 | Professional | None | $63.10 | $104.71 | $120.23 |
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 $69.18 Median $104.71 Typical High $169.82 | Professional | None | $69.18 | $104.71 | $169.82 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $281.84 Typical High $1,380.38 | Facility | None | $54.95 | $281.84 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $512.86 Typical High $851.14 | Professional | None | $100.00 | $512.86 | $851.14 |
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 $60.26 Median $102.33 Typical High $177.83 | Professional | None | $60.26 | $102.33 | $177.83 |
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 $24.55 Median $40.74 Typical High $50.12 | Professional | 52 · Reduced service | $24.55 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $16.60 Typical High $19.95 | Professional | 53 · Discontinued | $9.77 | $16.60 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $61.66 Typical High $75.86 | Professional | 54 · Surgery only | $36.31 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $12.30 Typical High $15.14 | Professional | 55 · Aftercare only | $7.41 | $12.30 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $8.13 Typical High $10.00 | Professional | 56 · Pre-op care only | $4.90 | $8.13 | $10.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $33.88 Median $57.54 Typical High $70.79 | Professional | 78 · Unplanned return to OR | $33.88 | $57.54 | $70.79 |
Where Missouri sits
The same service costs 3.9 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· 35th of 51
$105
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.