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 $467.74 Median $3,715.35 Typical High $7,762.47 | Facility | None | $467.74 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $346.74 Typical High $478.63 | Professional | None | $257.04 | $346.74 | $478.63 |
Ambetter Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
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 $288.40 Median $380.19 Typical High $512.86 | Professional | None | $288.40 | $380.19 | $512.86 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $436.52 Median $575.44 Typical High $776.25 | Professional | 50 · Both sides | $436.52 | $575.44 | $776.25 |
BCBS Kansas City Setting Professional Modifier None Typical Low $295.12 Median $446.68 Typical High $549.54 | Professional | None | $295.12 | $446.68 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $416.87 Typical High $2,691.53 | Facility | None | $275.42 | $416.87 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $436.52 Typical High $707.95 | Professional | None | $257.04 | $436.52 | $707.95 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,445.44 Typical High $3,467.37 | Facility | None | $54.95 | $1,445.44 | $3,467.37 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $2,344.23 Typical High $3,388.44 | Professional | None | $478.63 | $2,344.23 | $3,388.44 |
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 $309.03 Median $467.74 Typical High $707.95 | Professional | None | $309.03 | $467.74 | $707.95 |
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 $128.82 Median $186.21 Typical High $234.42 | Professional | 52 · Reduced service | $128.82 | $186.21 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $75.86 Typical High $93.33 | Professional | 53 · Discontinued | $51.29 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $281.84 Typical High $346.74 | Professional | 54 · Surgery only | $190.55 | $281.84 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $56.23 Typical High $69.18 | Professional | 55 · Aftercare only | $38.90 | $56.23 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $38.02 Typical High $46.77 | Professional | 56 · Pre-op care only | $25.70 | $38.02 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $263.03 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $177.83 | $263.03 | $323.59 |
Where Missouri sits
The same service costs 4.5 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· 28th of 51
$479
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.