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 $26.92 Median $1,698.24 Typical High $6,309.57 | Facility | None | $26.92 | $1,698.24 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $33.88 Typical High $64.57 | Professional | None | $18.20 | $33.88 | $64.57 |
Ambetter Setting Professional Modifier None Typical Low $20.89 Median $45.71 Typical High $56.23 | Professional | None | $20.89 | $45.71 | $56.23 |
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 $25.70 Median $42.66 Typical High $67.61 | Professional | None | $25.70 | $42.66 | $67.61 |
BCBS Kansas City Setting Professional Modifier None Typical Low $22.39 Median $43.65 Typical High $50.12 | Professional | None | $22.39 | $43.65 | $50.12 |
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 $23.99 Median $40.74 Typical High $61.66 | Professional | None | $23.99 | $40.74 | $61.66 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $177.83 Typical High $1,288.25 | Facility | None | $54.95 | $177.83 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $40.74 Median $177.83 Typical High $338.84 | Professional | None | $40.74 | $177.83 | $338.84 |
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 $21.88 Median $40.74 Typical High $72.44 | Professional | None | $21.88 | $40.74 | $72.44 |
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 $9.12 Median $16.60 Typical High $22.91 | Professional | 52 · Reduced service | $9.12 | $16.60 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $6.61 Typical High $9.12 | Professional | 53 · Discontinued | $3.63 | $6.61 | $9.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $13.80 Median $25.12 Typical High $34.67 | Professional | 54 · Surgery only | $13.80 | $25.12 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $5.01 Typical High $6.92 | Professional | 55 · Aftercare only | $2.75 | $5.01 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $3.31 Typical High $4.57 | Professional | 56 · Pre-op care only | $1.82 | $3.31 | $4.57 |
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
$47.86
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.