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 $93.33 Median $4,677.35 Typical High $7,762.47 | Facility | None | $93.33 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $100.00 Typical High $114.82 | Professional | None | $81.28 | $100.00 | $114.82 |
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 $75.86 Median $87.10 Typical High $154.88 | Professional | None | $75.86 | $87.10 | $154.88 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $114.82 Median $128.82 Typical High $223.87 | Professional | 50 · Both sides | $114.82 | $128.82 | $223.87 |
BCBS Kansas City Setting Professional Modifier None Typical Low $72.44 Median $93.33 Typical High $117.49 | Professional | None | $72.44 | $93.33 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $66.07 | Facility | None | $50.12 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $93.33 Typical High $173.78 | Professional | None | $77.62 | $93.33 | $173.78 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $251.19 Typical High $1,288.25 | Facility | None | $54.95 | $251.19 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $109.65 Median $588.84 Typical High $1,047.13 | Professional | None | $109.65 | $588.84 | $1,047.13 |
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 $87.10 Median $112.20 Typical High $162.18 | Professional | None | $87.10 | $112.20 | $162.18 |
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 $40.74 Median $47.86 Typical High $57.54 | Professional | 52 · Reduced service | $40.74 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $19.05 Typical High $22.91 | Professional | 53 · Discontinued | $16.22 | $19.05 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $70.79 Typical High $87.10 | Professional | 54 · Surgery only | $60.26 | $70.79 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $14.13 Typical High $17.38 | Professional | 55 · Aftercare only | $12.02 | $14.13 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $9.55 Typical High $11.48 | Professional | 56 · Pre-op care only | $8.13 | $9.55 | $11.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $56.23 Median $66.07 Typical High $81.28 | Professional | 78 · Unplanned return to OR | $56.23 | $66.07 | $81.28 |
Where Missouri sits
The same service costs 4.2 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· 32nd of 51
$115
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.