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 $58.88 Median $2,511.89 Typical High $6,309.57 | Facility | None | $58.88 | $2,511.89 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $114.82 Typical High $194.98 | Professional | None | $41.69 | $114.82 | $194.98 |
Ambetter Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $162.18 | Professional | None | $26.30 | $26.30 | $162.18 |
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 $58.88 Median $120.23 Typical High $204.17 | Professional | None | $58.88 | $120.23 | $204.17 |
BCBS Kansas City Setting Professional Modifier None Typical Low $48.98 Median $144.54 Typical High $165.96 | Professional | None | $48.98 | $144.54 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $169.82 Typical High $1,659.59 | Facility | None | $114.82 | $169.82 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $125.89 Typical High $204.17 | Professional | None | $57.54 | $125.89 | $204.17 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $575.44 Typical High $1,949.84 | Facility | None | $54.95 | $575.44 | $1,949.84 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $549.54 Typical High $1,148.15 | Professional | None | $134.90 | $549.54 | $1,148.15 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $2,344.23 | Facility | None | $398.11 | $1,148.15 | $2,344.23 |
United Setting Professional Modifier None Typical Low $53.70 Median $123.03 Typical High $239.88 | Professional | None | $53.70 | $123.03 | $239.88 |
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 $20.42 Median $57.54 Typical High $69.18 | Professional | 52 · Reduced service | $20.42 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $22.91 Typical High $27.54 | Professional | 53 · Discontinued | $8.32 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $85.11 Typical High $102.33 | Professional | 54 · Surgery only | $30.90 | $85.11 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $16.98 Typical High $20.42 | Professional | 55 · Aftercare only | $6.17 | $16.98 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $11.48 Typical High $13.80 | Professional | 56 · Pre-op care only | $4.07 | $11.48 | $13.80 |
Where Missouri sits
The same service costs 2.6 times more in Alaska than in Montana. 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· 34th of 51
$141
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.