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 $239.88 Median $3,162.28 Typical High $7,762.47 | Facility | None | $239.88 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $199.53 Typical High $251.19 | Professional | None | $125.89 | $199.53 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
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 $107.15 Median $154.88 Typical High $257.04 | Professional | None | $107.15 | $154.88 | $257.04 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $162.18 Median $234.42 Typical High $380.19 | Professional | 50 · Both sides | $162.18 | $234.42 | $380.19 |
BCBS Kansas City Setting Professional Modifier None Typical Low $138.04 Median $229.09 Typical High $309.03 | Professional | None | $138.04 | $229.09 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $181.97 Typical High $263.03 | Facility | None | $58.88 | $181.97 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $234.42 Typical High $457.09 | Professional | None | $141.25 | $234.42 | $457.09 |
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 $245.47 Median $1,071.52 Typical High $1,737.80 | Professional | None | $245.47 | $1,071.52 | $1,737.80 |
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 $151.36 Median $251.19 Typical High $446.68 | Professional | None | $151.36 | $251.19 | $446.68 |
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 $63.10 Median $100.00 Typical High $120.23 | Professional | 52 · Reduced service | $63.10 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $39.81 Typical High $47.86 | Professional | 53 · Discontinued | $25.12 | $39.81 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $147.91 Typical High $181.97 | Professional | 54 · Surgery only | $95.50 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $29.51 Typical High $36.31 | Professional | 55 · Aftercare only | $19.05 | $29.51 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $19.95 Typical High $23.99 | Professional | 56 · Pre-op care only | $12.59 | $19.95 | $23.99 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $138.04 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $89.13 | $138.04 | $169.82 |
Where Missouri sits
The same service costs 4.6 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· 31st of 51
$240
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.