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 $60.26 Median $4,677.35 Typical High $7,762.47 | Facility | None | $60.26 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $60.26 Typical High $74.13 | Professional | None | $38.02 | $60.26 | $74.13 |
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 $75.86 Typical High $117.49 | Professional | None | $52.48 | $75.86 | $117.49 |
BCBS Kansas City Setting Professional Modifier None Typical Low $45.71 Median $85.11 Typical High $97.72 | Professional | None | $45.71 | $85.11 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $83.18 | Facility | None | $50.12 | $66.07 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $70.79 Typical High $117.49 | Professional | None | $47.86 | $70.79 | $117.49 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $239.88 Typical High $1,288.25 | Facility | None | $54.95 | $239.88 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $66.07 Median $549.54 Typical High $616.60 | Professional | None | $66.07 | $549.54 | $616.60 |
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 $44.67 Median $74.13 Typical High $125.89 | Professional | None | $44.67 | $74.13 | $125.89 |
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 $19.05 Median $28.18 Typical High $36.31 | Professional | 52 · Reduced service | $19.05 | $28.18 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $11.22 Typical High $14.45 | Professional | 53 · Discontinued | $7.59 | $11.22 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $41.69 Typical High $53.70 | Professional | 54 · Surgery only | $28.84 | $41.69 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $8.32 Typical High $10.96 | Professional | 55 · Aftercare only | $5.75 | $8.32 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $5.62 Typical High $7.24 | Professional | 56 · Pre-op care only | $3.80 | $5.62 | $7.24 |
Where Missouri sits
The same service costs 3.4 times more in Alaska than in New York. 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· 28th of 51
$81.28
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.