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 $134.90 Median $3,162.28 Typical High $7,762.47 | Facility | None | $134.90 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $109.65 Typical High $144.54 | Professional | None | $50.12 | $109.65 | $144.54 |
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 $75.86 Median $114.82 Typical High $234.42 | Professional | None | $75.86 | $114.82 | $234.42 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $112.20 Median $173.78 Typical High $346.74 | Professional | 50 · Both sides | $112.20 | $173.78 | $346.74 |
BCBS Kansas City Setting Professional Modifier None Typical Low $64.57 Median $158.49 Typical High $218.78 | Professional | None | $64.57 | $158.49 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $954.99 Typical High $1,659.59 | Facility | None | $446.68 | $954.99 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $144.54 Typical High $309.03 | Professional | None | $67.61 | $144.54 | $309.03 |
Medica Setting Facility Modifier None Typical Low $173.78 Median $1,445.44 Typical High $12,022.64 | Facility | None | $173.78 | $1,445.44 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $138.04 Median $676.08 Typical High $1,096.48 | Professional | None | $138.04 | $676.08 | $1,096.48 |
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 $66.07 Median $134.90 Typical High $257.04 | Professional | None | $66.07 | $134.90 | $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 $25.12 Median $54.95 Typical High $66.07 | Professional | 52 · Reduced service | $25.12 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $22.39 Typical High $26.92 | Professional | 53 · Discontinued | $10.00 | $22.39 | $26.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $83.18 Typical High $100.00 | Professional | 54 · Surgery only | $38.02 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $16.60 Typical High $19.95 | Professional | 55 · Aftercare only | $7.59 | $16.60 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $10.96 Typical High $13.49 | Professional | 56 · Pre-op care only | $5.01 | $10.96 | $13.49 |
Where Missouri sits
The same service costs 4.9 times more in Alaska than in Hawaii. 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· 37th of 51
$145
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.