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 $52.48 Median $1,778.28 Typical High $6,309.57 | Facility | None | $52.48 | $1,778.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $131.83 Typical High $223.87 | Professional | None | $41.69 | $131.83 | $223.87 |
Ambetter Setting Professional Modifier None Typical Low $38.90 Median $47.86 Typical High $165.96 | Professional | None | $38.90 | $47.86 | $165.96 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $3,981.07 Typical High $7,762.47 | Facility | None | $2,238.72 | $3,981.07 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $74.13 Typical High $100.00 | Professional | None | $53.70 | $74.13 | $100.00 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $81.28 Median $109.65 Typical High $151.36 | Professional | 50 · Both sides | $81.28 | $109.65 | $151.36 |
BCBS Kansas City Setting Professional Modifier None Typical Low $44.67 Median $147.91 Typical High $204.17 | Professional | None | $44.67 | $147.91 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $147.91 Typical High $275.42 | Professional | None | $51.29 | $147.91 | $275.42 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $239.88 Typical High $1,230.27 | Facility | None | $54.95 | $239.88 | $1,230.27 |
Medica Setting Professional Modifier None Typical Low $165.96 Median $602.56 Typical High $1,778.28 | Professional | None | $165.96 | $602.56 | $1,778.28 |
Qualchoice Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $257.04 | Professional | None | $74.13 | $74.13 | $257.04 |
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 $57.54 Median $141.25 Typical High $251.19 | Professional | None | $57.54 | $141.25 | $251.19 |
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 $20.89 Median $54.95 Typical High $85.11 | Professional | 52 · Reduced service | $20.89 | $54.95 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $21.88 Typical High $33.88 | Professional | 53 · Discontinued | $8.32 | $21.88 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $83.18 Typical High $128.82 | Professional | 54 · Surgery only | $31.62 | $83.18 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $16.60 Typical High $25.70 | Professional | 55 · Aftercare only | $6.31 | $16.60 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $10.96 Typical High $16.98 | Professional | 56 · Pre-op care only | $4.17 | $10.96 | $16.98 |
Where Missouri sits
The same service costs 3.9 times more in Alaska than in Virginia. 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· 27th of 51
$141
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.