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 $16.22 Median $1,819.70 Typical High $6,309.57 | Facility | None | $16.22 | $1,819.70 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $25.12 Typical High $50.12 | Professional | None | $11.22 | $25.12 | $50.12 |
Ambetter Setting Professional Modifier None Typical Low $26.92 Median $38.02 Typical High $38.02 | Professional | None | $26.92 | $38.02 | $38.02 |
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 $15.14 Median $28.84 Typical High $46.77 | Professional | None | $15.14 | $28.84 | $46.77 |
BCBS Kansas City Setting Professional Modifier None Typical Low $13.49 Median $31.62 Typical High $36.31 | Professional | None | $13.49 | $31.62 | $36.31 |
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 $14.45 Median $30.20 Typical High $44.67 | Professional | None | $14.45 | $30.20 | $44.67 |
Medica Setting Facility Modifier None Typical Low $37.15 Median $177.83 Typical High $1,288.25 | Facility | None | $37.15 | $177.83 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $29.51 Median $125.89 Typical High $245.47 | Professional | None | $29.51 | $125.89 | $245.47 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $2,137.96 | Facility | None | $123.03 | $537.03 | $2,137.96 |
United Setting Professional Modifier None Typical Low $13.18 Median $28.18 Typical High $52.48 | Professional | None | $13.18 | $28.18 | $52.48 |
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 $5.62 Median $12.30 Typical High $16.60 | Professional | 52 · Reduced service | $5.62 | $12.30 | $16.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $5.01 Typical High $6.61 | Professional | 53 · Discontinued | $2.24 | $5.01 | $6.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.51 Median $18.62 Typical High $25.12 | Professional | 54 · Surgery only | $8.51 | $18.62 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $3.72 Typical High $5.01 | Professional | 55 · Aftercare only | $1.70 | $3.72 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $2.51 Typical High $3.31 | Professional | 56 · Pre-op care only | $1.12 | $2.51 | $3.31 |
Where Missouri sits
The same service costs 3.5 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· 20th of 51
$33.11
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.