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 $154.88 Median $3,162.28 Typical High $7,762.47 | Facility | None | $154.88 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $154.88 | Professional | None | $102.33 | $131.83 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $100.00 Median $125.89 Typical High $162.18 | Professional | None | $100.00 | $125.89 | $162.18 |
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 $128.82 Typical High $177.83 | Professional | None | $102.33 | $128.82 | $177.83 |
BCBS Kansas City Setting Professional Modifier None Typical Low $89.13 Median $128.82 Typical High $144.54 | Professional | None | $89.13 | $128.82 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $120.23 Typical High $1,659.59 | Facility | None | $81.28 | $120.23 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $125.89 Typical High $208.93 | Professional | None | $97.72 | $125.89 | $208.93 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $660.69 Typical High $11,481.54 | Facility | None | $125.89 | $660.69 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $117.49 Median $758.58 Typical High $954.99 | Professional | None | $117.49 | $758.58 | $954.99 |
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 $95.50 Median $125.89 Typical High $213.80 | Professional | None | $95.50 | $125.89 | $213.80 |
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 $52.48 Median $64.57 Typical High $77.62 | Professional | 52 · Reduced service | $52.48 | $64.57 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $25.70 Typical High $30.90 | Professional | 53 · Discontinued | $20.89 | $25.70 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $95.50 Typical High $114.82 | Professional | 54 · Surgery only | $79.43 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $19.05 Typical High $23.44 | Professional | 55 · Aftercare only | $15.85 | $19.05 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.88 Typical High $15.49 | Professional | 56 · Pre-op care only | $10.47 | $12.88 | $15.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $89.13 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $74.13 | $89.13 | $107.15 |
Where Missouri sits
The same service costs 4.0 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· 30th of 51
$145
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.