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 $109.65 Median $2,754.23 Typical High $6,309.57 | Facility | None | $109.65 | $2,754.23 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $154.88 Typical High $229.09 | Professional | None | $61.66 | $154.88 | $229.09 |
Ambetter Setting Professional Modifier None Typical Low $72.44 Median $120.23 Typical High $234.42 | Professional | None | $72.44 | $120.23 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $3,981.07 Typical High $7,079.46 | Facility | None | $2,238.72 | $3,981.07 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $107.15 Typical High $144.54 | Professional | None | $79.43 | $107.15 | $144.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $117.49 Median $162.18 Typical High $213.80 | Professional | 50 · Both sides | $117.49 | $162.18 | $213.80 |
BCBS Kansas City Setting Professional Modifier None Typical Low $64.57 Median $173.78 Typical High $239.88 | Professional | None | $64.57 | $173.78 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $181.97 Typical High $331.13 | Professional | None | $74.13 | $181.97 | $331.13 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $323.59 Typical High $1,230.27 | Facility | None | $54.95 | $323.59 | $1,230.27 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $741.31 Typical High $2,511.89 | Professional | None | $194.98 | $741.31 | $2,511.89 |
Qualchoice Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
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 $85.11 Median $181.97 Typical High $323.59 | Professional | None | $85.11 | $181.97 | $323.59 |
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 $30.90 Median $66.07 Typical High $102.33 | Professional | 52 · Reduced service | $30.90 | $66.07 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $26.30 Typical High $40.74 | Professional | 53 · Discontinued | $12.30 | $26.30 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $102.33 Typical High $154.88 | Professional | 54 · Surgery only | $45.71 | $102.33 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $19.50 Typical High $30.90 | Professional | 55 · Aftercare only | $9.12 | $19.50 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $13.18 Typical High $20.42 | Professional | 56 · Pre-op care only | $6.17 | $13.18 | $20.42 |
Where Missouri sits
The same service costs 3.8 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· 29th of 51
$174
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.