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 $107.15 Median $2,511.89 Typical High $6,309.57 | Facility | None | $107.15 | $2,511.89 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $114.82 Typical High $213.80 | Professional | None | $67.61 | $114.82 | $213.80 |
Ambetter Setting Professional Modifier None Typical Low $67.61 Median $74.13 Typical High $128.82 | Professional | None | $67.61 | $74.13 | $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 $89.13 Median $141.25 Typical High $218.78 | Professional | None | $89.13 | $141.25 | $218.78 |
BCBS Kansas City Setting Professional Modifier None Typical Low $87.10 Median $154.88 Typical High $177.83 | Professional | None | $87.10 | $154.88 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $141.25 Typical High $1,659.59 | Facility | None | $93.33 | $141.25 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $147.91 Typical High $234.42 | Professional | None | $95.50 | $147.91 | $234.42 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $794.33 Typical High $3,090.30 | Facility | None | $54.95 | $794.33 | $3,090.30 |
Medica Setting Professional Modifier None Typical Low $144.54 Median $3,162.28 Typical High $3,630.78 | Professional | None | $144.54 | $3,162.28 | $3,630.78 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,235.94 | Facility | None | $562.34 | $1,513.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $87.10 Median $144.54 Typical High $251.19 | Professional | None | $87.10 | $144.54 | $251.19 |
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 $57.54 Typical High $70.79 | Professional | 52 · Reduced service | $33.88 | $57.54 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $23.44 Typical High $28.18 | Professional | 53 · Discontinued | $13.49 | $23.44 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $87.10 Typical High $104.71 | Professional | 54 · Surgery only | $51.29 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $17.38 Typical High $20.89 | Professional | 55 · Aftercare only | $10.23 | $17.38 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $11.48 Typical High $14.13 | Professional | 56 · Pre-op care only | $6.76 | $11.48 | $14.13 |
Where Missouri sits
The same service costs 3.2 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· 32nd 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.