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 $14.79 Median $4,677.35 Typical High $7,762.47 | Facility | None | $14.79 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $12.02 Median $15.85 Typical High $25.12 | Professional | None | $12.02 | $15.85 | $25.12 |
Ambetter Setting Professional Modifier None Typical Low $14.79 Median $19.95 Typical High $23.44 | Professional | None | $14.79 | $19.95 | $23.44 |
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 $16.98 Median $20.89 Typical High $28.84 | Professional | None | $16.98 | $20.89 | $28.84 |
BCBS Kansas City Setting Professional Modifier None Typical Low $13.49 Median $18.20 Typical High $21.38 | Professional | None | $13.49 | $18.20 | $21.38 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $2,691.53 Typical High $2,691.53 | Facility | None | $50.12 | $2,691.53 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $15.14 Median $18.62 Typical High $35.48 | Professional | None | $15.14 | $18.62 | $35.48 |
Medica Setting Facility Modifier None Typical Low $23.44 Median $380.19 Typical High $11,481.54 | Facility | None | $23.44 | $380.19 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $16.22 Median $38.90 Typical High $199.53 | Professional | None | $16.22 | $38.90 | $199.53 |
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 $14.45 Median $20.42 Typical High $34.67 | Professional | None | $14.45 | $20.42 | $34.67 |
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 $6.03 Median $6.92 Typical High $8.13 | Professional | 52 · Reduced service | $6.03 | $6.92 | $8.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.40 Median $2.75 Typical High $3.31 | Professional | 53 · Discontinued | $2.40 | $2.75 | $3.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $9.12 Median $10.47 Typical High $12.30 | Professional | 54 · Surgery only | $9.12 | $10.47 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.82 Median $2.09 Typical High $2.45 | Professional | 55 · Aftercare only | $1.82 | $2.09 | $2.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.38 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.20 | $1.38 | $1.62 |
Where Missouri sits
The same service costs 3.9 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· 25th of 51
$21.88
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.