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 $4,677.35 Typical High $7,762.47 | Facility | None | $316.23 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $346.74 | Professional | None | $234.42 | $281.84 | $346.74 |
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 $1,318.26 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $281.84 Median $338.84 Typical High $512.86 | Professional | None | $281.84 | $338.84 | $512.86 |
BCBS Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $416.87 | Professional | None | $269.15 | $323.59 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $1,122.02 Typical High $2,691.53 | Facility | None | $645.65 | $1,122.02 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $338.84 Typical High $616.60 | Professional | None | $257.04 | $338.84 | $616.60 |
Medica Setting Facility Modifier None Typical Low $467.74 Median $2,344.23 Typical High $26,302.68 | Facility | None | $467.74 | $2,344.23 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $354.81 Median $2,137.96 Typical High $3,090.30 | Professional | None | $354.81 | $2,137.96 | $3,090.30 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,370.32 | Facility | None | $1,000.00 | $2,818.38 | $5,370.32 |
United Setting Professional Modifier None Typical Low $263.03 Median $371.54 Typical High $602.56 | Professional | None | $263.03 | $371.54 | $602.56 |
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 $117.49 Median $141.25 Typical High $173.78 | Professional | 52 · Reduced service | $117.49 | $141.25 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $56.23 Typical High $69.18 | Professional | 53 · Discontinued | $46.77 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $213.80 Typical High $263.03 | Professional | 54 · Surgery only | $177.83 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $42.66 Typical High $52.48 | Professional | 55 · Aftercare only | $35.48 | $42.66 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $28.18 Typical High $34.67 | Professional | 56 · Pre-op care only | $23.44 | $28.18 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $199.53 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $165.96 | $199.53 | $245.47 |
Where Missouri sits
The same service costs 6.8 times more in Alaska than in Utah. 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.