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 $245.47 Median $3,162.28 Typical High $7,762.47 | Facility | None | $245.47 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $208.93 Typical High $257.04 | Professional | None | $120.23 | $208.93 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $208.93 Typical High $218.78 | Professional | None | $114.82 | $208.93 | $218.78 |
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 $128.82 Median $181.97 Typical High $295.12 | Professional | None | $128.82 | $181.97 | $295.12 |
BCBS Kansas City Setting Professional Modifier None Typical Low $123.03 Median $223.87 Typical High $302.00 | Professional | None | $123.03 | $223.87 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $251.19 Typical High $1,659.59 | Facility | None | $165.96 | $251.19 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $208.93 Typical High $346.74 | Professional | None | $125.89 | $208.93 | $346.74 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $912.01 Typical High $2,951.21 | Facility | None | $54.95 | $912.01 | $2,951.21 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $977.24 Typical High $1,698.24 | Professional | None | $269.15 | $977.24 | $1,698.24 |
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 $147.91 Median $245.47 Typical High $416.87 | Professional | None | $147.91 | $245.47 | $416.87 |
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 $60.26 Median $104.71 Typical High $123.03 | Professional | 52 · Reduced service | $60.26 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $41.69 Typical High $48.98 | Professional | 53 · Discontinued | $23.99 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $154.88 Typical High $186.21 | Professional | 54 · Surgery only | $91.20 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $30.90 Typical High $37.15 | Professional | 55 · Aftercare only | $18.20 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $20.89 Typical High $24.55 | Professional | 56 · Pre-op care only | $12.02 | $20.89 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $144.54 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $85.11 | $144.54 | $173.78 |
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· 28th of 51
$219
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.