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 $26.30 Median $2,511.89 Typical High $6,309.57 | Facility | None | $26.30 | $2,511.89 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $54.95 Typical High $104.71 | Professional | None | $16.22 | $54.95 | $104.71 |
Ambetter Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $120.23 | Professional | None | $75.86 | $75.86 | $120.23 |
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 $23.44 Median $39.81 Typical High $85.11 | Professional | None | $23.44 | $39.81 | $85.11 |
BCBS Kansas City Setting Professional Modifier None Typical Low $20.89 Median $77.62 Typical High $89.13 | Professional | None | $20.89 | $77.62 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $66.07 | Facility | None | $50.12 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $56.23 Typical High $100.00 | Professional | None | $22.39 | $56.23 | $100.00 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $181.97 Typical High $1,288.25 | Facility | None | $54.95 | $181.97 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $52.48 Median $309.03 Typical High $616.60 | Professional | None | $52.48 | $309.03 | $616.60 |
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 $20.42 Median $48.98 Typical High $112.20 | Professional | None | $20.42 | $48.98 | $112.20 |
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 $8.13 Median $21.88 Typical High $36.31 | Professional | 52 · Reduced service | $8.13 | $21.88 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $8.71 Typical High $14.45 | Professional | 53 · Discontinued | $3.24 | $8.71 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.02 Median $33.11 Typical High $53.70 | Professional | 54 · Surgery only | $12.02 | $33.11 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $6.61 Typical High $10.96 | Professional | 55 · Aftercare only | $2.40 | $6.61 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $4.37 Typical High $7.24 | Professional | 56 · Pre-op care only | $1.62 | $4.37 | $7.24 |
Where Missouri sits
The same service costs 3.4 times more in Wisconsin 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· 43rd 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.