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 $851.14 Median $3,162.28 Typical High $7,762.47 | Facility | None | $851.14 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $95.50 Typical High $190.55 | Professional | None | $77.62 | $95.50 | $190.55 |
Ambetter Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $61.66 | Professional | None | $45.71 | $45.71 | $61.66 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,819.70 Typical High $3,981.07 | Facility | None | $724.44 | $1,819.70 | $3,981.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $158.49 Typical High $204.17 | Professional | None | $109.65 | $158.49 | $204.17 |
BCBS Kansas City Setting Professional Modifier None Typical Low $97.72 Median $104.71 Typical High $147.91 | Professional | None | $97.72 | $104.71 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $234.42 | Professional | None | $100.00 | $134.90 | $234.42 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $331.13 Typical High $1,288.25 | Facility | None | $54.95 | $331.13 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $104.71 Median $776.25 Typical High $776.25 | Professional | None | $104.71 | $776.25 | $776.25 |
Qualchoice Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
United Setting Facility Modifier None Typical Low $245.47 Median $870.96 Typical High $3,548.13 | Facility | None | $245.47 | $870.96 | $3,548.13 |
United Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $208.93 | Professional | None | $95.50 | $138.04 | $208.93 |
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 $38.90 Median $46.77 Typical High $51.29 | Professional | 52 · Reduced service | $38.90 | $46.77 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $18.62 Typical High $20.42 | Professional | 53 · Discontinued | $15.49 | $18.62 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $69.18 Typical High $75.86 | Professional | 54 · Surgery only | $58.88 | $69.18 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $13.80 Typical High $15.49 | Professional | 55 · Aftercare only | $11.75 | $13.80 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $9.33 Typical High $10.23 | Professional | 56 · Pre-op care only | $7.76 | $9.33 | $10.23 |
Where Missouri sits
The same service costs 3.5 times more in Wisconsin 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· 20th of 51
$151
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.