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 $128.82 Median $3,162.28 Typical High $7,762.47 | Facility | None | $128.82 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $107.15 Typical High $204.17 | Professional | None | $67.61 | $107.15 | $204.17 |
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 $97.72 Median $144.54 Typical High $218.78 | Professional | None | $97.72 | $144.54 | $218.78 |
BCBS Kansas City Setting Professional Modifier None Typical Low $83.18 Median $144.54 Typical High $162.18 | Professional | None | $83.18 | $144.54 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $117.49 Typical High $1,659.59 | Facility | None | $77.62 | $117.49 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $141.25 Typical High $218.78 | Professional | None | $95.50 | $141.25 | $218.78 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $537.03 Typical High $1,949.84 | Facility | None | $54.95 | $537.03 | $1,949.84 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $676.08 Typical High $1,071.52 | Professional | None | $134.90 | $676.08 | $1,071.52 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $2,238.72 | Facility | None | $398.11 | $1,148.15 | $2,238.72 |
United Setting Professional Modifier None Typical Low $85.11 Median $138.04 Typical High $239.88 | Professional | None | $85.11 | $138.04 | $239.88 |
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 $33.88 Median $53.70 Typical High $64.57 | Professional | 52 · Reduced service | $33.88 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $21.38 Typical High $25.70 | Professional | 53 · Discontinued | $13.49 | $21.38 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $79.43 Typical High $95.50 | Professional | 54 · Surgery only | $51.29 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $15.85 Typical High $19.50 | Professional | 55 · Aftercare only | $10.23 | $15.85 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $10.72 Typical High $12.88 | Professional | 56 · Pre-op care only | $6.76 | $10.72 | $12.88 |
Where Missouri sits
The same service costs 3.2 times more in Alaska than in Florida. 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
$155
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.