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 $47.86 Median $2,511.89 Typical High $7,762.47 | Facility | None | $47.86 | $2,511.89 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $89.13 Typical High $144.54 | Professional | None | $37.15 | $89.13 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $151.36 | Professional | None | $109.65 | $144.54 | $151.36 |
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 $52.48 Median $87.10 Typical High $154.88 | Professional | None | $52.48 | $87.10 | $154.88 |
BCBS Kansas City Setting Professional Modifier None Typical Low $43.65 Median $112.20 Typical High $125.89 | Professional | None | $43.65 | $112.20 | $125.89 |
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 $51.29 Median $102.33 Typical High $165.96 | Professional | None | $51.29 | $102.33 | $165.96 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $234.42 Typical High $1,380.38 | Facility | None | $54.95 | $234.42 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $457.09 Typical High $912.01 | Professional | None | $93.33 | $457.09 | $912.01 |
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 $46.77 Median $93.33 Typical High $190.55 | Professional | None | $46.77 | $93.33 | $190.55 |
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 $18.62 Median $35.48 Typical High $53.70 | Professional | 52 · Reduced service | $18.62 | $35.48 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $14.45 Typical High $21.38 | Professional | 53 · Discontinued | $7.59 | $14.45 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $53.70 Typical High $81.28 | Professional | 54 · Surgery only | $28.18 | $53.70 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $10.72 Typical High $16.22 | Professional | 55 · Aftercare only | $5.62 | $10.72 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $7.08 Typical High $10.72 | Professional | 56 · Pre-op care only | $3.72 | $7.08 | $10.72 |
Where Missouri sits
The same service costs 3.5 times more in Alaska 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· 31st of 51
$100
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.