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 $218.78 Median $3,715.35 Typical High $7,762.47 | Facility | None | $218.78 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $181.97 Typical High $229.09 | Professional | None | $114.82 | $181.97 | $229.09 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 50 · Both sides | $134.90 | $134.90 | $134.90 |
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 $131.83 Median $186.21 Typical High $354.81 | Professional | None | $131.83 | $186.21 | $354.81 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $199.53 Median $275.42 Typical High $512.86 | Professional | 50 · Both sides | $199.53 | $275.42 | $512.86 |
BCBS Kansas City Setting Professional Modifier None Typical Low $123.03 Median $204.17 Typical High $281.84 | Professional | None | $123.03 | $204.17 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $245.47 Typical High $2,691.53 | Facility | None | $162.18 | $245.47 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $208.93 Typical High $416.87 | Professional | None | $128.82 | $208.93 | $416.87 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $933.25 Typical High $3,090.30 | Facility | None | $54.95 | $933.25 | $3,090.30 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $977.24 Typical High $1,584.89 | Professional | None | $218.78 | $977.24 | $1,584.89 |
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 $138.04 Median $229.09 Typical High $398.11 | Professional | None | $138.04 | $229.09 | $398.11 |
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 $56.23 Median $89.13 Typical High $109.65 | Professional | 52 · Reduced service | $56.23 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $36.31 Typical High $43.65 | Professional | 53 · Discontinued | $22.91 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $134.90 Typical High $162.18 | Professional | 54 · Surgery only | $85.11 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $26.92 Typical High $32.36 | Professional | 55 · Aftercare only | $16.98 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $18.20 Typical High $21.88 | Professional | 56 · Pre-op care only | $11.48 | $18.20 | $21.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $125.89 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $79.43 | $125.89 | $151.36 |
Where Missouri sits
The same service costs 3.9 times more in Oklahoma 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· 35th of 51
$219
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.