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 $186.21 Median $3,162.28 Typical High $7,762.47 | Facility | None | $186.21 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $199.53 | Professional | None | $125.89 | $154.88 | $199.53 |
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 $141.25 Median $158.49 Typical High $239.88 | Professional | None | $141.25 | $158.49 | $239.88 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $213.80 Median $234.42 Typical High $354.81 | Professional | 50 · Both sides | $213.80 | $234.42 | $354.81 |
BCBS Kansas City Setting Professional Modifier None Typical Low $154.88 Median $194.98 Typical High $251.19 | Professional | None | $154.88 | $194.98 | $251.19 |
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 $125.89 Median $190.55 Typical High $323.59 | Professional | None | $125.89 | $190.55 | $323.59 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $331.13 Typical High $1,548.82 | Facility | None | $54.95 | $331.13 | $1,548.82 |
Medica Setting Professional Modifier None Typical Low $186.21 Median $1,148.15 Typical High $1,380.38 | Professional | None | $186.21 | $1,148.15 | $1,380.38 |
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 $138.04 Median $199.53 Typical High $331.13 | Professional | None | $138.04 | $199.53 | $331.13 |
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 $63.10 Median $77.62 Typical High $93.33 | Professional | 52 · Reduced service | $63.10 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $30.90 Typical High $37.15 | Professional | 53 · Discontinued | $25.12 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $114.82 Typical High $141.25 | Professional | 54 · Surgery only | $95.50 | $114.82 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $23.44 Typical High $28.18 | Professional | 55 · Aftercare only | $19.05 | $23.44 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $15.49 Typical High $18.62 | Professional | 56 · Pre-op care only | $12.59 | $15.49 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $107.15 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $89.13 | $107.15 | $131.83 |
Where Missouri sits
The same service costs 4.6 times more in Alaska than in Florida. 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· 34th of 51
$191
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.