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 $1,698.24 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $109.65 Typical High $2,511.89 | Professional | None | $67.61 | $109.65 | $2,511.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $102.33 Typical High $131.83 | Professional | None | $91.20 | $102.33 | $131.83 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $138.04 Median $154.88 Typical High $194.98 | Professional | 50 · Both sides | $138.04 | $154.88 | $194.98 |
Medica Setting Facility Modifier None Typical Low $302.00 Median $3,019.95 Typical High $6,918.31 | Facility | None | $302.00 | $3,019.95 | $6,918.31 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $158.49 Typical High $223.87 | Professional | None | $100.00 | $158.49 | $223.87 |
United Setting Facility Modifier None Typical Low $1,698.24 Median $3,235.94 Typical High $7,244.36 | Facility | None | $1,698.24 | $3,235.94 | $7,244.36 |
United Setting Professional Modifier None Typical Low $107.15 Median $169.82 Typical High $223.87 | Professional | None | $107.15 | $169.82 | $223.87 |
5 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 $33.88 Median $54.95 Typical High $66.07 | Professional | 52 · Reduced service | $33.88 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $21.88 Typical High $26.30 | Professional | 53 · Discontinued | $13.49 | $21.88 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $81.28 Typical High $100.00 | Professional | 54 · Surgery only | $50.12 | $81.28 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $16.22 Typical High $19.95 | Professional | 55 · Aftercare only | $10.00 | $16.22 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $10.96 Typical High $13.18 | Professional | 56 · Pre-op care only | $6.76 | $10.96 | $13.18 |
Where Missouri sits
The same service costs 51.3 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· 49th of 51
$126
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.