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 $141.25 Median $4,677.35 Typical High $7,762.47 | Facility | None | $141.25 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $218.78 | Professional | None | $112.20 | $147.91 | $218.78 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $158.49 Typical High $186.21 | Professional | None | $114.82 | $158.49 | $186.21 |
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 $100.00 Median $134.90 Typical High $257.04 | Professional | None | $100.00 | $134.90 | $257.04 |
BCBS Kansas City Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $190.55 | Professional | None | $102.33 | $144.54 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $66.07 | Facility | None | $50.12 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $154.88 Typical High $281.84 | Professional | None | $114.82 | $154.88 | $281.84 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $309.03 Typical High $1,288.25 | Facility | None | $54.95 | $309.03 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $154.88 Median $831.76 Typical High $1,096.48 | Professional | None | $154.88 | $831.76 | $1,096.48 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,137.96 | Facility | None | $123.03 | $602.56 | $2,137.96 |
United Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $407.38 | Professional | None | $123.03 | $169.82 | $407.38 |
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 $72.44 Typical High $91.20 | Professional | 52 · Reduced service | $56.23 | $72.44 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $29.51 Typical High $36.31 | Professional | 53 · Discontinued | $22.39 | $29.51 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $109.65 Typical High $134.90 | Professional | 54 · Surgery only | $85.11 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $21.88 Typical High $26.92 | Professional | 55 · Aftercare only | $16.98 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $14.79 Typical High $18.20 | Professional | 56 · Pre-op care only | $11.22 | $14.79 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $102.33 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $79.43 | $102.33 | $125.89 |
Where Missouri sits
The same service costs 4.1 times more in Alaska 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
$162
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.