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 $812.83 Median $3,162.28 Typical High $7,762.47 | Facility | None | $812.83 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $173.78 Typical High $229.09 | Professional | None | $52.48 | $173.78 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $208.93 Typical High $363.08 | Professional | None | $81.28 | $208.93 | $363.08 |
BCBS Kansas City Setting Professional Modifier None Typical Low $69.18 Median $229.09 Typical High $323.59 | Professional | None | $69.18 | $229.09 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,137.96 Typical High $2,691.53 | Facility | None | $575.44 | $2,137.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $208.93 Typical High $524.81 | Professional | None | $70.79 | $208.93 | $524.81 |
Medica Setting Facility Modifier None Typical Low $114.82 Median $331.13 Typical High $1,258.93 | Facility | None | $114.82 | $331.13 | $1,258.93 |
Medica Setting Professional Modifier None Typical Low $251.19 Median $831.76 Typical High $1,737.80 | Professional | None | $251.19 | $831.76 | $1,737.80 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $2,137.96 | Facility | None | $123.03 | $549.54 | $2,137.96 |
United Setting Professional Modifier None Typical Low $81.28 Median $213.80 Typical High $446.68 | Professional | None | $81.28 | $213.80 | $446.68 |
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 $26.30 Median $54.95 Typical High $104.71 | Professional | 52 · Reduced service | $26.30 | $54.95 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $21.88 Typical High $41.69 | Professional | 53 · Discontinued | $10.47 | $21.88 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $83.18 Typical High $158.49 | Professional | 54 · Surgery only | $39.81 | $83.18 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $16.60 Typical High $31.62 | Professional | 55 · Aftercare only | $7.94 | $16.60 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $10.96 Typical High $20.89 | Professional | 56 · Pre-op care only | $5.25 | $10.96 | $20.89 |
Where Missouri sits
The same service costs 4.5 times more in Oklahoma than in Nebraska. 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· 26th of 51
$245
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.