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 $218.78 Median $3,162.28 Typical High $6,309.57 | Facility | None | $218.78 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $199.53 Typical High $245.47 | Professional | None | $102.33 | $199.53 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
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 $81.28 Median $162.18 Typical High $281.84 | Professional | None | $81.28 | $162.18 | $281.84 |
BCBS Kansas City Setting Professional Modifier None Typical Low $104.71 Median $204.17 Typical High $281.84 | Professional | None | $104.71 | $204.17 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $851.14 Typical High $1,659.59 | Facility | None | $446.68 | $851.14 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $190.55 Typical High $331.13 | Professional | None | $107.15 | $190.55 | $331.13 |
Medica Setting Facility Modifier None Typical Low $234.42 Median $1,445.44 Typical High $12,022.64 | Facility | None | $234.42 | $1,445.44 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $812.83 Typical High $1,621.81 | Professional | None | $263.03 | $812.83 | $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 $123.03 Median $208.93 Typical High $389.05 | Professional | None | $123.03 | $208.93 | $389.05 |
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 $91.20 Typical High $117.49 | Professional | 52 · Reduced service | $51.29 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $36.31 Typical High $46.77 | Professional | 53 · Discontinued | $20.42 | $36.31 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $138.04 Typical High $173.78 | Professional | 54 · Surgery only | $75.86 | $138.04 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $27.54 Typical High $34.67 | Professional | 55 · Aftercare only | $15.14 | $27.54 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $18.20 Typical High $23.44 | Professional | 56 · Pre-op care only | $10.23 | $18.20 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $128.82 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $70.79 | $128.82 | $162.18 |
Where Missouri sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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· 27th of 51
$204
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.