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 $69.18 Median $2,951.21 Typical High $6,309.57 | Facility | None | $69.18 | $2,951.21 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $69.18 Typical High $128.82 | Professional | None | $40.74 | $69.18 | $128.82 |
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 $60.26 Median $97.72 Typical High $165.96 | Professional | None | $60.26 | $97.72 | $165.96 |
BCBS Kansas City Setting Professional Modifier None Typical Low $51.29 Median $93.33 Typical High $107.15 | Professional | None | $51.29 | $93.33 | $107.15 |
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 $56.23 Median $95.50 Typical High $147.91 | Professional | None | $56.23 | $95.50 | $147.91 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $251.19 Typical High $1,288.25 | Facility | None | $54.95 | $251.19 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $91.20 Median $407.38 Typical High $707.95 | Professional | None | $91.20 | $407.38 | $707.95 |
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 $53.70 Median $91.20 Typical High $154.88 | Professional | None | $53.70 | $91.20 | $154.88 |
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 $20.42 Median $34.67 Typical High $41.69 | Professional | 52 · Reduced service | $20.42 | $34.67 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $13.80 Typical High $16.60 | Professional | 53 · Discontinued | $8.13 | $13.80 | $16.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $51.29 Typical High $63.10 | Professional | 54 · Surgery only | $30.90 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $10.47 Typical High $12.59 | Professional | 55 · Aftercare only | $6.17 | $10.47 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $6.92 Typical High $8.32 | Professional | 56 · Pre-op care only | $4.07 | $6.92 | $8.32 |
Where Missouri sits
The same service costs 3.2 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· 26th of 51
$102
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.