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 $389.05 Median $2,951.21 Typical High $6,309.57 | Facility | None | $389.05 | $2,951.21 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $346.74 Typical High $630.96 | Professional | None | $281.84 | $346.74 | $630.96 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $501.19 | Professional | None | $295.12 | $295.12 | $501.19 |
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 $275.42 Median $323.59 Typical High $467.74 | Professional | None | $275.42 | $323.59 | $467.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $416.87 Median $489.78 Typical High $707.95 | Professional | 50 · Both sides | $416.87 | $489.78 | $707.95 |
BCBS Kansas City Setting Professional Modifier None Typical Low $338.84 Median $389.05 Typical High $489.78 | Professional | None | $338.84 | $389.05 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $141.25 Typical High $199.53 | Facility | None | $58.88 | $141.25 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $363.08 Typical High $630.96 | Professional | None | $281.84 | $363.08 | $630.96 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $380.19 Typical High $1,584.89 | Facility | None | $54.95 | $380.19 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $338.84 Median $2,511.89 Typical High $2,630.27 | Professional | None | $338.84 | $2,511.89 | $2,630.27 |
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 $288.40 Median $380.19 Typical High $676.08 | Professional | None | $288.40 | $380.19 | $676.08 |
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 $141.25 Median $169.82 Typical High $190.55 | Professional | 52 · Reduced service | $141.25 | $169.82 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $67.61 Typical High $75.86 | Professional | 53 · Discontinued | $56.23 | $67.61 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $251.19 Typical High $281.84 | Professional | 54 · Surgery only | $208.93 | $251.19 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $51.29 Typical High $56.23 | Professional | 55 · Aftercare only | $41.69 | $51.29 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $33.88 Typical High $38.02 | Professional | 56 · Pre-op care only | $28.18 | $33.88 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $234.42 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $194.98 | $234.42 | $263.03 |
Where Missouri sits
The same service costs 5.6 times more in Alaska than in Texas. 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· 33rd of 51
$363
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.