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 $323.59 Median $3,715.35 Typical High $6,309.57 | Facility | None | $323.59 | $3,715.35 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $269.15 Typical High $338.84 | Professional | None | $162.18 | $269.15 | $338.84 |
Ambetter Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $181.97 Typical High $275.42 | Professional | None | $158.49 | $181.97 | $275.42 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $234.42 Median $275.42 Typical High $416.87 | Professional | 50 · Both sides | $234.42 | $275.42 | $416.87 |
BCBS Setting Professional Modifier None Typical Low $138.04 Median $263.03 Typical High $302.00 | Professional | None | $138.04 | $263.03 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $302.00 Typical High $1,659.59 | Facility | None | $204.17 | $302.00 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $251.19 Typical High $407.38 | Professional | None | $151.36 | $251.19 | $407.38 |
Medica Setting Facility Modifier None Typical Low $354.81 Median $1,023.29 Typical High $3,090.30 | Facility | None | $354.81 | $1,023.29 | $3,090.30 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $1,174.90 Typical High $2,238.72 | Professional | None | $263.03 | $1,174.90 | $2,238.72 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,235.94 | Facility | None | $562.34 | $1,513.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $144.54 Median $257.04 Typical High $457.09 | Professional | None | $144.54 | $257.04 | $457.09 |
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 $81.28 Median $120.23 Typical High $169.82 | Professional | 52 · Reduced service | $81.28 | $120.23 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $47.86 Typical High $67.61 | Professional | 53 · Discontinued | $32.36 | $47.86 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $181.97 Typical High $251.19 | Professional | 54 · Surgery only | $120.23 | $181.97 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $36.31 Typical High $50.12 | Professional | 55 · Aftercare only | $23.99 | $36.31 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $23.99 Typical High $33.88 | Professional | 56 · Pre-op care only | $16.22 | $23.99 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $169.82 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $112.20 | $169.82 | $234.42 |
Where Missouri sits
The same service costs 3.8 times more in Wyoming 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· 31st of 51
$275
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.