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 $134.90 Median $3,162.28 Typical High $6,309.57 | Facility | None | $134.90 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $208.93 | Professional | None | $97.72 | $123.03 | $208.93 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $131.83 Typical High $213.80 | Professional | None | $123.03 | $131.83 | $213.80 |
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 $125.89 Median $181.97 Typical High $223.87 | Professional | None | $125.89 | $181.97 | $223.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $186.21 Median $269.15 Typical High $331.13 | Professional | 50 · Both sides | $186.21 | $269.15 | $331.13 |
BCBS Kansas City Setting Professional Modifier None Typical Low $109.65 Median $141.25 Typical High $177.83 | Professional | None | $109.65 | $141.25 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $128.82 Typical High $1,659.59 | Facility | None | $85.11 | $128.82 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $141.25 Typical High $257.04 | Professional | None | $114.82 | $141.25 | $257.04 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $331.13 Typical High $1,288.25 | Facility | None | $54.95 | $331.13 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $154.88 Median $1,412.54 Typical High $1,737.80 | Professional | None | $154.88 | $1,412.54 | $1,737.80 |
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 $109.65 Median $204.17 Typical High $295.12 | Professional | None | $109.65 | $204.17 | $295.12 |
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 $48.98 Median $58.88 Typical High $69.18 | Professional | 52 · Reduced service | $48.98 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $23.44 Typical High $28.18 | Professional | 53 · Discontinued | $19.50 | $23.44 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $89.13 Typical High $104.71 | Professional | 54 · Surgery only | $74.13 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $17.78 Typical High $20.89 | Professional | 55 · Aftercare only | $14.79 | $17.78 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $11.75 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.77 | $11.75 | $13.80 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $83.18 Typical High $97.72 | Professional | 78 · Unplanned return to OR | $69.18 | $83.18 | $97.72 |
Where Missouri sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 17th of 51
$186
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.