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 $134.90 Median $3,162.28 Typical High $6,309.57 | Facility | None | $134.90 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $134.90 Typical High $165.96 | Professional | None | $102.33 | $134.90 | $165.96 |
Ambetter Setting Professional Modifier None Typical Low $79.43 Median $144.54 Typical High $234.42 | Professional | None | $79.43 | $144.54 | $234.42 |
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 $107.15 Median $138.04 Typical High $213.80 | Professional | None | $107.15 | $138.04 | $213.80 |
BCBS Kansas City Setting Professional Modifier None Typical Low $104.71 Median $151.36 Typical High $208.93 | Professional | None | $104.71 | $151.36 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $147.91 Typical High $1,659.59 | Facility | None | $97.72 | $147.91 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $239.88 | Professional | None | $107.15 | $141.25 | $239.88 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $812.83 Typical High $3,090.30 | Facility | None | $54.95 | $812.83 | $3,090.30 |
Medica Setting Professional Modifier None Typical Low $186.21 Median $831.76 Typical High $1,096.48 | Professional | None | $186.21 | $831.76 | $1,096.48 |
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 $114.82 Median $173.78 Typical High $281.84 | Professional | None | $114.82 | $173.78 | $281.84 |
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 $67.61 Typical High $79.43 | Professional | 52 · Reduced service | $51.29 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $26.92 Typical High $31.62 | Professional | 53 · Discontinued | $20.42 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $102.33 Typical High $117.49 | Professional | 54 · Surgery only | $75.86 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $20.42 Typical High $23.44 | Professional | 55 · Aftercare only | $15.14 | $20.42 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $13.49 Typical High $15.85 | Professional | 56 · Pre-op care only | $10.23 | $13.49 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $95.50 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $70.79 | $95.50 | $109.65 |
Where Missouri sits
The same service costs 4.0 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· 30th of 51
$158
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.