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 $46.77 Median $3,162.28 Typical High $6,309.57 | Facility | None | $46.77 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $42.66 Typical High $66.07 | Professional | None | $19.95 | $42.66 | $66.07 |
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 $29.51 Median $47.86 Typical High $70.79 | Professional | None | $29.51 | $47.86 | $70.79 |
BCBS Kansas City Setting Professional Modifier None Typical Low $25.70 Median $57.54 Typical High $64.57 | Professional | None | $25.70 | $57.54 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $50.12 Typical High $66.07 | Facility | None | $37.15 | $50.12 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $53.70 Typical High $81.28 | Professional | None | $28.18 | $53.70 | $81.28 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $181.97 Typical High $1,737.80 | Facility | None | $54.95 | $181.97 | $1,737.80 |
Medica Setting Professional Modifier None Typical Low $50.12 Median $223.87 Typical High $446.68 | Professional | None | $50.12 | $223.87 | $446.68 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,137.96 | Facility | None | $123.03 | $602.56 | $2,137.96 |
United Setting Professional Modifier None Typical Low $25.12 Median $50.12 Typical High $89.13 | Professional | None | $25.12 | $50.12 | $89.13 |
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 $10.00 Median $20.42 Typical High $25.70 | Professional | 52 · Reduced service | $10.00 | $20.42 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $8.13 Typical High $10.23 | Professional | 53 · Discontinued | $3.98 | $8.13 | $10.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.79 Median $30.20 Typical High $38.02 | Professional | 54 · Surgery only | $14.79 | $30.20 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $6.03 Typical High $7.59 | Professional | 55 · Aftercare only | $2.95 | $6.03 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $4.07 Typical High $5.13 | Professional | 56 · Pre-op care only | $2.00 | $4.07 | $5.13 |
Where Missouri sits
The same service costs 3.3 times more in Alaska than in New Jersey. 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· 27th of 51
$54.95
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.