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 $147.91 Median $3,162.28 Typical High $6,309.57 | Facility | None | $147.91 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $147.91 Typical High $263.03 | Professional | None | $102.33 | $147.91 | $263.03 |
Ambetter Setting Professional Modifier None Typical Low $141.25 Median $245.47 Typical High $288.40 | Professional | None | $141.25 | $245.47 | $288.40 |
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 $120.23 Median $154.88 Typical High $302.00 | Professional | None | $120.23 | $154.88 | $302.00 |
BCBS Kansas City Setting Professional Modifier None Typical Low $123.03 Median $186.21 Typical High $245.47 | Professional | None | $123.03 | $186.21 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $186.21 Typical High $2,691.53 | Facility | None | $123.03 | $186.21 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $186.21 Typical High $331.13 | Professional | None | $123.03 | $186.21 | $331.13 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $1,445.44 Typical High $11,481.54 | Facility | None | $199.53 | $1,445.44 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $1,000.00 Typical High $1,445.44 | Professional | None | $151.36 | $1,000.00 | $1,445.44 |
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 $128.82 Median $181.97 Typical High $363.08 | Professional | None | $128.82 | $181.97 | $363.08 |
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 $74.13 Typical High $91.20 | Professional | 52 · Reduced service | $51.29 | $74.13 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $29.51 Typical High $37.15 | Professional | 53 · Discontinued | $20.42 | $29.51 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $112.20 Typical High $138.04 | Professional | 54 · Surgery only | $77.62 | $112.20 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $22.39 Typical High $27.54 | Professional | 55 · Aftercare only | $15.49 | $22.39 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $14.79 Typical High $18.62 | Professional | 56 · Pre-op care only | $10.23 | $14.79 | $18.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $104.71 Typical High $128.82 | Professional | 78 · Unplanned return to OR | $72.44 | $104.71 | $128.82 |
Where Missouri sits
The same service costs 3.9 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· 36th of 51
$182
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.