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 $181.97 Median $3,162.28 Typical High $7,762.47 | Facility | None | $181.97 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $169.82 Typical High $204.17 | Professional | None | $102.33 | $169.82 | $204.17 |
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 $89.13 Median $112.20 Typical High $204.17 | Professional | None | $89.13 | $112.20 | $204.17 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $134.90 Median $169.82 Typical High $309.03 | Professional | 50 · Both sides | $134.90 | $169.82 | $309.03 |
BCBS Kansas City Setting Professional Modifier None Typical Low $104.71 Median $181.97 Typical High $251.19 | Professional | None | $104.71 | $181.97 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $134.90 Typical High $190.55 | Facility | None | $58.88 | $134.90 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $181.97 Typical High $371.54 | Professional | None | $107.15 | $181.97 | $371.54 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $309.03 Typical High $1,513.56 | Facility | None | $54.95 | $309.03 | $1,513.56 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $831.76 Typical High $1,380.38 | Professional | None | $199.53 | $831.76 | $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 $120.23 Median $204.17 Typical High $346.74 | Professional | None | $120.23 | $204.17 | $346.74 |
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 $50.12 Median $85.11 Typical High $95.50 | Professional | 52 · Reduced service | $50.12 | $85.11 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $33.88 Typical High $38.02 | Professional | 53 · Discontinued | $20.42 | $33.88 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $128.82 Typical High $141.25 | Professional | 54 · Surgery only | $75.86 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $25.70 Typical High $28.84 | Professional | 55 · Aftercare only | $15.14 | $25.70 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $16.98 Typical High $19.05 | Professional | 56 · Pre-op care only | $10.23 | $16.98 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $120.23 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $70.79 | $120.23 | $131.83 |
Where Missouri sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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
$182
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.