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 $128.82 Median $2,754.23 Typical High $6,309.57 | Facility | None | $128.82 | $2,754.23 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $128.82 Typical High $223.87 | Professional | None | $102.33 | $128.82 | $223.87 |
Ambetter Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $208.93 | Professional | None | $128.82 | $165.96 | $208.93 |
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 $114.82 Median $134.90 Typical High $213.80 | Professional | None | $114.82 | $134.90 | $213.80 |
BCBS Kansas City Setting Professional Modifier None Typical Low $114.82 Median $154.88 Typical High $194.98 | Professional | None | $114.82 | $154.88 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $87.10 Typical High $562.34 | Facility | None | $66.07 | $87.10 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $158.49 Typical High $275.42 | Professional | None | $120.23 | $158.49 | $275.42 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $295.12 Typical High $1,071.52 | Facility | None | $54.95 | $295.12 | $1,071.52 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $870.96 Typical High $1,096.48 | Professional | None | $177.83 | $870.96 | $1,096.48 |
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 $117.49 Median $213.80 Typical High $295.12 | Professional | None | $117.49 | $213.80 | $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 $51.29 Median $64.57 Typical High $79.43 | Professional | 52 · Reduced service | $51.29 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $25.70 Typical High $31.62 | Professional | 53 · Discontinued | $20.42 | $25.70 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $95.50 Typical High $117.49 | Professional | 54 · Surgery only | $77.62 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $19.50 Typical High $23.99 | Professional | 55 · Aftercare only | $15.49 | $19.50 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.88 Typical High $15.85 | Professional | 56 · Pre-op care only | $10.23 | $12.88 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $89.13 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $72.44 | $89.13 | $109.65 |
Where Missouri sits
The same service costs 3.9 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· 36th of 51
$166
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.