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 $158.49 Median $3,162.28 Typical High $6,309.57 | Facility | None | $158.49 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $177.83 | Professional | None | $120.23 | $151.36 | $177.83 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $194.98 Median $194.98 Typical High $281.84 | Professional | 50 · Both sides | $194.98 | $194.98 | $281.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $204.17 Median $3,467.37 Typical High $7,079.46 | Facility | None | $204.17 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $117.49 Median $128.82 Typical High $199.53 | Professional | None | $117.49 | $128.82 | $199.53 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $173.78 Median $190.55 Typical High $302.00 | Professional | 50 · Both sides | $173.78 | $190.55 | $302.00 |
BCBS Kansas City Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $169.82 | Professional | None | $107.15 | $141.25 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $100.00 Typical High $141.25 | Facility | None | $58.88 | $100.00 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $141.25 Typical High $239.88 | Professional | None | $112.20 | $141.25 | $239.88 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $316.23 Typical High $1,288.25 | Facility | None | $54.95 | $316.23 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $870.96 Typical High $1,148.15 | Professional | None | $134.90 | $870.96 | $1,148.15 |
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 $144.54 Typical High $245.47 | Professional | None | $107.15 | $144.54 | $245.47 |
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 $72.44 Typical High $87.10 | Professional | 52 · Reduced service | $60.26 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $28.84 Typical High $35.48 | Professional | 53 · Discontinued | $23.99 | $28.84 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $107.15 Typical High $131.83 | Professional | 54 · Surgery only | $91.20 | $107.15 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $21.38 Typical High $26.30 | Professional | 55 · Aftercare only | $18.20 | $21.38 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $14.45 Typical High $17.38 | Professional | 56 · Pre-op care only | $12.02 | $14.45 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $100.00 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $85.11 | $100.00 | $123.03 |
Where Missouri sits
The same service costs 4.1 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· 31st of 51
$158
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.