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 $338.84 Median $5,128.61 Typical High $9,549.93 | Facility | None | $338.84 | $5,128.61 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $199.53 Typical High $263.03 | Professional | None | $104.71 | $199.53 | $263.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $4,265.80 Typical High $16,982.44 | Facility | None | $1,412.54 | $4,265.80 | $16,982.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $416.87 | Professional | None | $147.91 | $223.87 | $416.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $223.87 Median $331.13 Typical High $630.96 | Professional | 50 · Both sides | $223.87 | $331.13 | $630.96 |
BCBS Kansas City Setting Professional Modifier None Typical Low $131.83 Median $281.84 Typical High $389.05 | Professional | None | $131.83 | $281.84 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $2,137.96 Typical High $12,022.64 | Facility | None | $851.14 | $2,137.96 | $12,022.64 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $263.03 Typical High $575.44 | Professional | None | $138.04 | $263.03 | $575.44 |
Medica Setting Facility Modifier None Typical Low $281.84 Median $3,090.30 Typical High $7,079.46 | Facility | None | $281.84 | $3,090.30 | $7,079.46 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $1,174.90 Typical High $2,041.74 | Professional | None | $263.03 | $1,174.90 | $2,041.74 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,548.13 Typical High $7,585.78 | Facility | None | $1,000.00 | $3,548.13 | $7,585.78 |
United Setting Professional Modifier None Typical Low $138.04 Median $263.03 Typical High $467.74 | Professional | None | $138.04 | $263.03 | $467.74 |
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 $52.48 Median $100.00 Typical High $120.23 | Professional | 52 · Reduced service | $52.48 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $39.81 Typical High $48.98 | Professional | 53 · Discontinued | $20.89 | $39.81 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $151.36 Typical High $181.97 | Professional | 54 · Surgery only | $77.62 | $151.36 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $30.20 Typical High $36.31 | Professional | 55 · Aftercare only | $15.49 | $30.20 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $19.95 Typical High $23.99 | Professional | 56 · Pre-op care only | $10.47 | $19.95 | $23.99 |
Where Missouri sits
The same service costs 5.8 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· 33rd of 51
$275
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.