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 $117.49 Median $4,677.35 Typical High $7,762.47 | Facility | None | $117.49 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $117.49 Typical High $144.54 | Professional | None | $87.10 | $117.49 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
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 $77.62 Median $112.20 Typical High $213.80 | Professional | None | $77.62 | $112.20 | $213.80 |
BCBS Kansas City Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $162.18 | Professional | None | $85.11 | $123.03 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $120.23 Typical High $1,659.59 | Facility | None | $79.43 | $120.23 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $120.23 Typical High $234.42 | Professional | None | $91.20 | $120.23 | $234.42 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $281.84 Typical High $1,288.25 | Facility | None | $54.95 | $281.84 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $660.69 Typical High $870.96 | Professional | None | $125.89 | $660.69 | $870.96 |
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 $93.33 Median $131.83 Typical High $323.59 | Professional | None | $93.33 | $131.83 | $323.59 |
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 $43.65 Median $58.88 Typical High $72.44 | Professional | 52 · Reduced service | $43.65 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $23.44 Typical High $28.84 | Professional | 53 · Discontinued | $17.38 | $23.44 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $89.13 Typical High $109.65 | Professional | 54 · Surgery only | $66.07 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $17.78 Typical High $21.88 | Professional | 55 · Aftercare only | $13.18 | $17.78 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $11.75 Typical High $14.45 | Professional | 56 · Pre-op care only | $8.71 | $11.75 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $83.18 Typical High $102.33 | Professional | 78 · Unplanned return to OR | $61.66 | $83.18 | $102.33 |
Where Missouri sits
The same service costs 3.3 times more in Alaska than in Pennsylvania. 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
$132
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.