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 $125.89 Median $3,162.28 Typical High $6,309.57 | Facility | None | $125.89 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $107.15 Typical High $194.98 | Professional | None | $63.10 | $107.15 | $194.98 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $165.96 Typical High $177.83 | Professional | None | $107.15 | $165.96 | $177.83 |
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 $91.20 Median $125.89 Typical High $199.53 | Professional | None | $91.20 | $125.89 | $199.53 |
BCBS Kansas City Setting Professional Modifier None Typical Low $75.86 Median $138.04 Typical High $158.49 | Professional | None | $75.86 | $138.04 | $158.49 |
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 $89.13 Median $134.90 Typical High $218.78 | Professional | None | $89.13 | $134.90 | $218.78 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $281.84 Typical High $1,288.25 | Facility | None | $54.95 | $281.84 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $660.69 Typical High $1,122.02 | Professional | None | $125.89 | $660.69 | $1,122.02 |
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 $79.43 Median $134.90 Typical High $234.42 | Professional | None | $79.43 | $134.90 | $234.42 |
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 $31.62 Median $53.70 Typical High $66.07 | Professional | 52 · Reduced service | $31.62 | $53.70 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $21.88 Typical High $26.30 | Professional | 53 · Discontinued | $12.59 | $21.88 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $81.28 Typical High $97.72 | Professional | 54 · Surgery only | $47.86 | $81.28 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $16.22 Typical High $19.50 | Professional | 55 · Aftercare only | $9.55 | $16.22 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $10.96 Typical High $13.18 | Professional | 56 · Pre-op care only | $6.31 | $10.96 | $13.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $44.67 Median $75.86 Typical High $91.20 | Professional | 78 · Unplanned return to OR | $44.67 | $75.86 | $91.20 |
Where Missouri sits
The same service costs 3.5 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· 26th of 51
$145
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.