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 $288.40 Median $2,290.87 Typical High $6,309.57 | Facility | None | $288.40 | $2,290.87 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $588.84 | Professional | None | $234.42 | $338.84 | $588.84 |
Ambetter Setting Professional Modifier None Typical Low $257.04 Median $288.40 Typical High $457.09 | Professional | None | $257.04 | $288.40 | $457.09 |
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 $257.04 Median $371.54 Typical High $645.65 | Professional | None | $257.04 | $371.54 | $645.65 |
BCBS Kansas City Setting Professional Modifier None Typical Low $223.87 Median $346.74 Typical High $478.63 | Professional | None | $223.87 | $346.74 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,288.25 Typical High $2,187.76 | Facility | None | $602.56 | $1,288.25 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $354.81 Typical High $741.31 | Professional | None | $239.88 | $354.81 | $741.31 |
Medica Setting Facility Modifier None Typical Low $616.60 Median $2,691.53 Typical High $16,218.10 | Facility | None | $616.60 | $2,691.53 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $436.52 Median $1,737.80 Typical High $3,019.95 | Professional | None | $436.52 | $1,737.80 | $3,019.95 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $257.04 Median $436.52 Typical High $870.96 | Professional | None | $257.04 | $436.52 | $870.96 |
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 $117.49 Median $169.82 Typical High $204.17 | Professional | 52 · Reduced service | $117.49 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $67.61 Typical High $81.28 | Professional | 53 · Discontinued | $46.77 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $257.04 Typical High $309.03 | Professional | 54 · Surgery only | $173.78 | $257.04 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $51.29 Typical High $61.66 | Professional | 55 · Aftercare only | $34.67 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $33.88 Typical High $40.74 | Professional | 56 · Pre-op care only | $23.44 | $33.88 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $239.88 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $162.18 | $239.88 | $288.40 |
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· 26th of 51
$437
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.