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 $169.82 Median $3,162.28 Typical High $7,762.47 | Facility | None | $169.82 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $141.25 Typical High $269.15 | Professional | None | $89.13 | $141.25 | $269.15 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $234.42 Typical High $234.42 | Professional | None | $114.82 | $234.42 | $234.42 |
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 $128.82 Median $177.83 Typical High $281.84 | Professional | None | $128.82 | $177.83 | $281.84 |
BCBS Kansas City Setting Professional Modifier None Typical Low $104.71 Median $186.21 Typical High $208.93 | Professional | None | $104.71 | $186.21 | $208.93 |
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 $123.03 Median $181.97 Typical High $295.12 | Professional | None | $123.03 | $181.97 | $295.12 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $331.13 Typical High $1,288.25 | Facility | None | $54.95 | $331.13 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $912.01 Typical High $1,445.44 | Professional | None | $173.78 | $912.01 | $1,445.44 |
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 $112.20 Median $177.83 Typical High $316.23 | Professional | None | $112.20 | $177.83 | $316.23 |
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 $44.67 Median $70.79 Typical High $85.11 | Professional | 52 · Reduced service | $44.67 | $70.79 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $28.18 Typical High $33.88 | Professional | 53 · Discontinued | $17.78 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $107.15 Typical High $128.82 | Professional | 54 · Surgery only | $66.07 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $21.38 Typical High $25.70 | Professional | 55 · Aftercare only | $13.49 | $21.38 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $14.13 Typical High $16.98 | Professional | 56 · Pre-op care only | $8.91 | $14.13 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $100.00 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $61.66 | $100.00 | $120.23 |
Where Missouri sits
The same service costs 3.3 times more in Alaska than in Maryland. 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· 25th of 51
$195
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.