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 $147.91 Median $3,162.28 Typical High $7,762.47 | Facility | None | $147.91 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $117.49 Typical High $151.36 | Professional | None | $91.20 | $117.49 | $151.36 |
Ambetter Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
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 $104.71 Median $123.03 Typical High $190.55 | Professional | None | $104.71 | $123.03 | $190.55 |
BCBS Kansas City Setting Professional Modifier None Typical Low $125.89 Median $138.04 Typical High $173.78 | Professional | None | $125.89 | $138.04 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $91.20 Typical High $131.83 | Facility | None | $58.88 | $91.20 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $128.82 Typical High $223.87 | Professional | None | $102.33 | $128.82 | $223.87 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $331.13 Typical High $2,187.76 | Facility | None | $54.95 | $331.13 | $2,187.76 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $933.25 Typical High $933.25 | Professional | None | $125.89 | $933.25 | $933.25 |
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 $107.15 Median $147.91 Typical High $239.88 | Professional | None | $107.15 | $147.91 | $239.88 |
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 $51.29 Median $61.66 Typical High $67.61 | Professional | 52 · Reduced service | $51.29 | $61.66 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $25.12 Typical High $26.92 | Professional | 53 · Discontinued | $20.42 | $25.12 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $93.33 Typical High $102.33 | Professional | 54 · Surgery only | $77.62 | $93.33 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $18.62 Typical High $20.42 | Professional | 55 · Aftercare only | $15.49 | $18.62 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.59 Typical High $13.49 | Professional | 56 · Pre-op care only | $10.23 | $12.59 | $13.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $87.10 Typical High $95.50 | Professional | 78 · Unplanned return to OR | $72.44 | $87.10 | $95.50 |
Where Missouri sits
The same service costs 5.1 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· 35th of 51
$138
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.