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 $302.00 Median $3,162.28 Typical High $6,309.57 | Facility | None | $302.00 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $239.88 Typical High $346.74 | Professional | None | $120.23 | $239.88 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
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 $102.33 Median $125.89 Typical High $194.98 | Professional | None | $102.33 | $125.89 | $194.98 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $154.88 Median $186.21 Typical High $295.12 | Professional | 50 · Both sides | $154.88 | $186.21 | $295.12 |
BCBS Kansas City Setting Professional Modifier None Typical Low $104.71 Median $263.03 Typical High $309.03 | Professional | None | $104.71 | $263.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $257.04 Typical High $1,659.59 | Facility | None | $169.82 | $257.04 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $245.47 Typical High $398.11 | Professional | None | $112.20 | $245.47 | $398.11 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $331.13 Typical High $1,621.81 | Facility | None | $54.95 | $331.13 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $1,047.13 Typical High $2,089.30 | Professional | None | $257.04 | $1,047.13 | $2,089.30 |
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 $107.15 Median $234.42 Typical High $446.68 | Professional | None | $107.15 | $234.42 | $446.68 |
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 $60.26 Median $117.49 Typical High $169.82 | Professional | 52 · Reduced service | $60.26 | $117.49 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $46.77 Typical High $67.61 | Professional | 53 · Discontinued | $23.99 | $46.77 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $177.83 Typical High $257.04 | Professional | 54 · Surgery only | $89.13 | $177.83 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $35.48 Typical High $51.29 | Professional | 55 · Aftercare only | $17.78 | $35.48 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $23.44 Typical High $33.88 | Professional | 56 · Pre-op care only | $12.02 | $23.44 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $165.96 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $83.18 | $165.96 | $239.88 |
Where Missouri sits
The same service costs 4.2 times more in Wisconsin 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· 30th of 51
$251
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.