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 $234.42 Median $3,162.28 Typical High $7,762.47 | Facility | None | $234.42 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $199.53 Typical High $263.03 | Professional | None | $114.82 | $199.53 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
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 $125.89 Median $181.97 Typical High $331.13 | Professional | None | $125.89 | $181.97 | $331.13 |
BCBS Kansas City Setting Professional Modifier None Typical Low $117.49 Median $208.93 Typical High $288.40 | Professional | None | $117.49 | $208.93 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $245.47 Typical High $2,691.53 | Facility | None | $165.96 | $245.47 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $208.93 Typical High $416.87 | Professional | None | $120.23 | $208.93 | $416.87 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $870.96 Typical High $2,630.27 | Facility | None | $54.95 | $870.96 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $912.01 Typical High $1,621.81 | Professional | None | $257.04 | $912.01 | $1,621.81 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,235.94 | Facility | None | $562.34 | $1,513.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $154.88 Median $263.03 Typical High $489.78 | Professional | None | $154.88 | $263.03 | $489.78 |
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 $56.23 Median $97.72 Typical High $117.49 | Professional | 52 · Reduced service | $56.23 | $97.72 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $39.81 Typical High $46.77 | Professional | 53 · Discontinued | $22.91 | $39.81 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $147.91 Typical High $173.78 | Professional | 54 · Surgery only | $85.11 | $147.91 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $29.51 Typical High $34.67 | Professional | 55 · Aftercare only | $16.98 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $19.95 Typical High $23.44 | Professional | 56 · Pre-op care only | $11.22 | $19.95 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $138.04 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $79.43 | $138.04 | $162.18 |
Where Missouri sits
The same service costs 3.8 times more in Wisconsin 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· 30th of 51
$229
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.