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 $257.04 Median $3,162.28 Typical High $6,309.57 | Facility | None | $257.04 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $223.87 Typical High $338.84 | Professional | None | $173.78 | $223.87 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
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 $177.83 Median $245.47 Typical High $407.38 | Professional | None | $177.83 | $245.47 | $407.38 |
BCBS Kansas City Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $302.00 | Professional | None | $154.88 | $223.87 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,412.54 Typical High $1,659.59 | Facility | None | $446.68 | $1,412.54 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $446.68 | Professional | None | $177.83 | $245.47 | $446.68 |
Medica Setting Facility Modifier None Typical Low $309.03 Median $1,445.44 Typical High $12,022.64 | Facility | None | $309.03 | $1,445.44 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $245.47 Median $562.34 Typical High $2,344.23 | Professional | None | $245.47 | $562.34 | $2,344.23 |
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 $190.55 Median $263.03 Typical High $630.96 | Professional | None | $190.55 | $263.03 | $630.96 |
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 $87.10 Median $112.20 Typical High $138.04 | Professional | 52 · Reduced service | $87.10 | $112.20 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $45.71 Typical High $56.23 | Professional | 53 · Discontinued | $34.67 | $45.71 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $169.82 Typical High $208.93 | Professional | 54 · Surgery only | $131.83 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $33.88 Typical High $41.69 | Professional | 55 · Aftercare only | $26.30 | $33.88 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $22.39 Typical High $27.54 | Professional | 56 · Pre-op care only | $17.38 | $22.39 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $158.49 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $123.03 | $158.49 | $194.98 |
Where Missouri sits
The same service costs 4.6 times more in Alaska than in Utah. 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· 25th of 51
$282
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.