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 $354.81 Median $5,623.41 Typical High $10,715.19 | Facility | None | $354.81 | $5,623.41 | $10,715.19 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $331.13 Typical High $562.34 | Professional | None | $281.84 | $331.13 | $562.34 |
Ambetter Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $3,801.89 Typical High $9,549.93 | Facility | None | $1,445.44 | $3,801.89 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $288.40 Median $676.08 Typical High $954.99 | Professional | None | $288.40 | $676.08 | $954.99 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $426.58 Median $1,023.29 Typical High $1,445.44 | Professional | 50 · Both sides | $426.58 | $1,023.29 | $1,445.44 |
BCBS Kansas City Setting Professional Modifier None Typical Low $239.88 Median $295.12 Typical High $389.05 | Professional | None | $239.88 | $295.12 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $380.19 Typical High $12,302.69 | Facility | None | $177.83 | $380.19 | $12,302.69 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $288.40 Typical High $724.44 | Professional | None | $257.04 | $288.40 | $724.44 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $1,288.25 Typical High $11,481.54 | Facility | None | $398.11 | $1,288.25 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $389.05 Median $3,235.94 Typical High $4,466.84 | Professional | None | $389.05 | $3,235.94 | $4,466.84 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $2,818.38 | Facility | None | $398.11 | $1,148.15 | $2,818.38 |
United Setting Professional Modifier None Typical Low $288.40 Median $501.19 Typical High $707.95 | Professional | None | $288.40 | $501.19 | $707.95 |
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 $141.25 Median $151.36 Typical High $177.83 | Professional | 52 · Reduced service | $141.25 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $61.66 Typical High $70.79 | Professional | 53 · Discontinued | $56.23 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $229.09 Typical High $263.03 | Professional | 54 · Surgery only | $208.93 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $45.71 Typical High $52.48 | Professional | 55 · Aftercare only | $42.66 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $30.20 Typical High $35.48 | Professional | 56 · Pre-op care only | $28.18 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $213.80 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $194.98 | $213.80 | $245.47 |
Where Missouri sits
The same service costs 5.0 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· 7th of 51
$646
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.