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 $316.23 Median $3,162.28 Typical High $6,309.57 | Facility | None | $316.23 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $302.00 Typical High $398.11 | Professional | None | $123.03 | $302.00 | $398.11 |
Ambetter Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
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 $141.25 Median $154.88 Typical High $245.47 | Professional | None | $141.25 | $154.88 | $245.47 |
BCBS Kansas City Setting Professional Modifier None Typical Low $141.25 Median $346.74 Typical High $457.09 | Professional | None | $141.25 | $346.74 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $954.99 Typical High $1,659.59 | Facility | None | $446.68 | $954.99 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $288.40 Typical High $562.34 | Professional | None | $147.91 | $288.40 | $562.34 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $1,445.44 Typical High $12,022.64 | Facility | None | $446.68 | $1,445.44 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $426.58 Median $1,348.96 Typical High $2,818.38 | Professional | None | $426.58 | $1,348.96 | $2,818.38 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,235.94 | Facility | None | $562.34 | $1,513.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $147.91 Median $323.59 Typical High $575.44 | Professional | None | $147.91 | $323.59 | $575.44 |
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 $61.66 Median $144.54 Typical High $186.21 | Professional | 52 · Reduced service | $61.66 | $144.54 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $57.54 Typical High $74.13 | Professional | 53 · Discontinued | $24.55 | $57.54 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $218.78 Typical High $275.42 | Professional | 54 · Surgery only | $91.20 | $218.78 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $43.65 Typical High $56.23 | Professional | 55 · Aftercare only | $18.20 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $28.84 Typical High $37.15 | Professional | 56 · Pre-op care only | $12.30 | $28.84 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $204.17 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $85.11 | $204.17 | $257.04 |
Where Missouri sits
The same service costs 4.0 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· 38th of 51
$302
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.