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 $162.18 Median $3,162.28 Typical High $6,309.57 | Facility | None | $162.18 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $162.18 Typical High $223.87 | Professional | None | $109.65 | $162.18 | $223.87 |
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 $100.00 Median $134.90 Typical High $218.78 | Professional | None | $100.00 | $134.90 | $218.78 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $151.36 Median $199.53 Typical High $323.59 | Professional | 50 · Both sides | $151.36 | $199.53 | $323.59 |
BCBS Kansas City Setting Professional Modifier None Typical Low $120.23 Median $190.55 Typical High $257.04 | Professional | None | $120.23 | $190.55 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $141.25 Typical High $199.53 | Facility | None | $58.88 | $141.25 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $186.21 Typical High $380.19 | Professional | None | $123.03 | $186.21 | $380.19 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $707.95 Typical High $1,949.84 | Facility | None | $54.95 | $707.95 | $1,949.84 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $933.25 Typical High $1,380.38 | Professional | None | $199.53 | $933.25 | $1,380.38 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $2,238.72 | Facility | None | $398.11 | $1,148.15 | $2,238.72 |
United Setting Professional Modifier None Typical Low $128.82 Median $204.17 Typical High $354.81 | Professional | None | $128.82 | $204.17 | $354.81 |
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 $54.95 Median $79.43 Typical High $95.50 | Professional | 52 · Reduced service | $54.95 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $32.36 Typical High $38.02 | Professional | 53 · Discontinued | $21.88 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $120.23 Typical High $144.54 | Professional | 54 · Surgery only | $83.18 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $23.99 Typical High $28.84 | Professional | 55 · Aftercare only | $16.60 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $15.85 Typical High $19.05 | Professional | 56 · Pre-op care only | $10.96 | $15.85 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $112.20 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $77.62 | $112.20 | $134.90 |
Where Missouri sits
The same service costs 4.1 times more in Alaska 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· 32nd of 51
$195
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.