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 $2.09 Median $1,819.70 Typical High $6,309.57 | Facility | None | $2.09 | $1,819.70 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $1.48 Median $4.90 Typical High $8.71 | Professional | None | $1.48 | $4.90 | $8.71 |
Ambetter Setting Professional Modifier None Typical Low $4.37 Median $5.13 Typical High $8.32 | Professional | None | $4.37 | $5.13 | $8.32 |
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 $2.57 Median $6.92 Typical High $15.85 | Professional | None | $2.57 | $6.92 | $15.85 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1.74 Median $6.03 Typical High $6.92 | Professional | None | $1.74 | $6.03 | $6.92 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $2,691.53 Typical High $2,691.53 | Facility | None | $50.12 | $2,691.53 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $2.04 Median $5.50 Typical High $10.23 | Professional | None | $2.04 | $5.50 | $10.23 |
Medica Setting Facility Modifier None Typical Low $8.91 Median $173.78 Typical High $1,288.25 | Facility | None | $8.91 | $173.78 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $6.03 Median $67.61 Typical High $186.21 | Professional | None | $6.03 | $67.61 | $186.21 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $2,137.96 | Facility | None | $123.03 | $549.54 | $2,137.96 |
United Setting Professional Modifier None Typical Low $2.14 Median $4.90 Typical High $10.47 | Professional | None | $2.14 | $4.90 | $10.47 |
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 $0.76 Median $1.95 Typical High $2.95 | Professional | 52 · Reduced service | $0.76 | $1.95 | $2.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.30 Median $0.78 Typical High $1.17 | Professional | 53 · Discontinued | $0.30 | $0.78 | $1.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.12 Median $2.95 Typical High $4.37 | Professional | 54 · Surgery only | $1.12 | $2.95 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.22 Median $0.59 Typical High $0.87 | Professional | 55 · Aftercare only | $0.22 | $0.59 | $0.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.39 Typical High $0.59 | Professional | 56 · Pre-op care only | $0.15 | $0.39 | $0.59 |
Where Missouri sits
The same service costs 3.0 times more in Alaska than in Nebraska. 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· 14th of 51
$7.41
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.