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 $389.05 Median $3,715.35 Typical High $7,762.47 | Facility | None | $389.05 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $389.05 | Professional | None | $245.47 | $338.84 | $389.05 |
Ambetter Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
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 $288.40 Median $380.19 Typical High $524.81 | Professional | None | $288.40 | $380.19 | $524.81 |
BCBS Kansas City Setting Professional Modifier None Typical Low $251.19 Median $371.54 Typical High $512.86 | Professional | None | $251.19 | $371.54 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,819.70 Typical High $2,187.76 | Facility | None | $602.56 | $1,819.70 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $354.81 Typical High $588.84 | Professional | None | $257.04 | $354.81 | $588.84 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $1,548.82 Typical High $16,218.10 | Facility | None | $436.52 | $1,548.82 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $457.09 Median $1,995.26 Typical High $2,691.53 | Professional | None | $457.09 | $1,995.26 | $2,691.53 |
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 $281.84 Median $436.52 Typical High $691.83 | Professional | None | $281.84 | $436.52 | $691.83 |
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 $123.03 Median $169.82 Typical High $194.98 | Professional | 52 · Reduced service | $123.03 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $67.61 Typical High $77.62 | Professional | 53 · Discontinued | $48.98 | $67.61 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $251.19 Typical High $295.12 | Professional | 54 · Surgery only | $181.97 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $50.12 Typical High $58.88 | Professional | 55 · Aftercare only | $37.15 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $33.88 Typical High $38.90 | Professional | 56 · Pre-op care only | $24.55 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $234.42 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $169.82 | $234.42 | $275.42 |
Where Missouri sits
The same service costs 4.1 times more in Alaska than in New Jersey. 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· 29th of 51
$389
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.