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 $51.29 Median $4,677.35 Typical High $7,762.47 | Facility | None | $51.29 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $89.13 Typical High $144.54 | Professional | None | $36.31 | $89.13 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $131.83 Median $134.90 Typical High $154.88 | Professional | None | $131.83 | $134.90 | $154.88 |
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 $53.70 Median $89.13 Typical High $154.88 | Professional | None | $53.70 | $89.13 | $154.88 |
BCBS Kansas City Setting Professional Modifier None Typical Low $42.66 Median $112.20 Typical High $128.82 | Professional | None | $42.66 | $112.20 | $128.82 |
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 $48.98 Median $104.71 Typical High $165.96 | Professional | None | $48.98 | $104.71 | $165.96 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $218.78 Typical High $1,380.38 | Facility | None | $54.95 | $218.78 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $95.50 Median $457.09 Typical High $912.01 | Professional | None | $95.50 | $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 $45.71 Median $93.33 Typical High $194.98 | Professional | None | $45.71 | $93.33 | $194.98 |
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 $18.20 Median $36.31 Typical High $54.95 | Professional | 52 · Reduced service | $18.20 | $36.31 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $14.79 Typical High $21.88 | Professional | 53 · Discontinued | $7.24 | $14.79 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $54.95 Typical High $81.28 | Professional | 54 · Surgery only | $26.92 | $54.95 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $10.96 Typical High $16.22 | Professional | 55 · Aftercare only | $5.37 | $10.96 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $7.24 Typical High $10.96 | Professional | 56 · Pre-op care only | $3.63 | $7.24 | $10.96 |
Where Missouri sits
The same service costs 3.4 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
$102
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.