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 $144.54 Median $3,162.28 Typical High $7,762.47 | Facility | None | $144.54 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $120.23 Typical High $158.49 | Professional | None | $56.23 | $120.23 | $158.49 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $134.90 | Professional | None | $95.50 | $95.50 | $134.90 |
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 $83.18 Median $128.82 Typical High $251.19 | Professional | None | $83.18 | $128.82 | $251.19 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $125.89 Median $190.55 Typical High $380.19 | Professional | 50 · Both sides | $125.89 | $190.55 | $380.19 |
BCBS Kansas City Setting Professional Modifier None Typical Low $67.61 Median $154.88 Typical High $208.93 | Professional | None | $67.61 | $154.88 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $158.49 Typical High $275.42 | Professional | None | $74.13 | $158.49 | $275.42 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $331.13 Typical High $1,258.93 | Facility | None | $54.95 | $331.13 | $1,258.93 |
Medica Setting Professional Modifier None Typical Low $158.49 Median $616.60 Typical High $1,737.80 | Professional | None | $158.49 | $616.60 | $1,737.80 |
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 $72.44 Median $151.36 Typical High $257.04 | Professional | None | $72.44 | $151.36 | $257.04 |
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 $28.18 Median $60.26 Typical High $75.86 | Professional | 52 · Reduced service | $28.18 | $60.26 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $23.99 Typical High $30.20 | Professional | 53 · Discontinued | $11.22 | $23.99 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $91.20 Typical High $114.82 | Professional | 54 · Surgery only | $41.69 | $91.20 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $18.20 Typical High $22.91 | Professional | 55 · Aftercare only | $8.32 | $18.20 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $12.02 Typical High $15.14 | Professional | 56 · Pre-op care only | $5.62 | $12.02 | $15.14 |
Where Missouri sits
The same service costs 2.6 times more in Wisconsin than in Utah. 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· 30th 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.