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 $1,778.28 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,778.28 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,445.44 | Professional | None | $660.69 | $660.69 | $1,445.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $120.23 Typical High $158.49 | Professional | None | $102.33 | $120.23 | $158.49 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $12.88 Median $151.36 Typical High $229.09 | Professional | 50 · Both sides | $12.88 | $151.36 | $229.09 |
BCBS Kansas City Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,230.27 | Professional | None | $912.01 | $912.01 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,398.83 Typical High $2,818.38 | Facility | None | $645.65 | $2,398.83 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $190.55 Typical High $891.25 | Professional | None | $120.23 | $190.55 | $891.25 |
Medica Setting Facility Modifier None Typical Low $851.14 Median $3,801.89 Typical High $26,302.68 | Facility | None | $851.14 | $3,801.89 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,801.89 | $3,801.89 | $3,801.89 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,467.37 | $6,918.31 |
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 $331.13 Median $331.13 Typical High $691.83 | Professional | 52 · Reduced service | $331.13 | $331.13 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $275.42 | Professional | 53 · Discontinued | $131.83 | $131.83 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $489.78 Typical High $1,023.29 | Professional | 54 · Surgery only | $489.78 | $489.78 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $208.93 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $138.04 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $138.04 |
Where Missouri sits
The same service costs 67.6 times more in Oklahoma than in Montana. 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· 31st of 51
$1,349
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.