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 $45.71 Median $2,754.23 Typical High $7,762.47 | Facility | None | $45.71 | $2,754.23 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $81.28 Typical High $134.90 | Professional | None | $33.88 | $81.28 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $138.04 | Professional | None | $91.20 | $91.20 | $138.04 |
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 $45.71 Median $77.62 Typical High $141.25 | Professional | None | $45.71 | $77.62 | $141.25 |
BCBS Kansas City Setting Professional Modifier None Typical Low $38.02 Median $107.15 Typical High $123.03 | Professional | None | $38.02 | $107.15 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $87.10 Typical High $123.03 | Facility | None | $58.88 | $87.10 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $95.50 Typical High $154.88 | Professional | None | $45.71 | $95.50 | $154.88 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $204.17 Typical High $1,380.38 | Facility | None | $54.95 | $204.17 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $436.52 Typical High $851.14 | Professional | None | $87.10 | $436.52 | $851.14 |
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 $40.74 Median $85.11 Typical High $181.97 | Professional | None | $40.74 | $85.11 | $181.97 |
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 $16.60 Median $32.36 Typical High $51.29 | Professional | 52 · Reduced service | $16.60 | $32.36 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $12.88 Typical High $20.42 | Professional | 53 · Discontinued | $6.76 | $12.88 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.12 Median $48.98 Typical High $77.62 | Professional | 54 · Surgery only | $25.12 | $48.98 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $9.77 Typical High $15.49 | Professional | 55 · Aftercare only | $5.01 | $9.77 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $6.46 Typical High $10.23 | Professional | 56 · Pre-op care only | $3.39 | $6.46 | $10.23 |
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· 37th of 51
$91.20
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.