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 $263.03 Median $3,162.28 Typical High $6,309.57 | Facility | None | $263.03 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $213.80 Typical High $346.74 | Professional | None | $69.18 | $213.80 | $346.74 |
Ambetter Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
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 $87.10 Median $123.03 Typical High $165.96 | Professional | None | $87.10 | $123.03 | $165.96 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $131.83 Median $186.21 Typical High $251.19 | Professional | 50 · Both sides | $131.83 | $186.21 | $251.19 |
BCBS Kansas City Setting Professional Modifier None Typical Low $72.44 Median $281.84 Typical High $416.87 | Professional | None | $72.44 | $281.84 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $229.09 Typical High $512.86 | Professional | None | $83.18 | $229.09 | $512.86 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $380.19 Typical High $1,258.93 | Facility | None | $54.95 | $380.19 | $1,258.93 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $1,148.15 Typical High $2,691.53 | Professional | None | $302.00 | $1,148.15 | $2,691.53 |
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 $93.33 Median $269.15 Typical High $478.63 | Professional | None | $93.33 | $269.15 | $478.63 |
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 $34.67 Median $87.10 Typical High $162.18 | Professional | 52 · Reduced service | $34.67 | $87.10 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $35.48 Typical High $64.57 | Professional | 53 · Discontinued | $13.80 | $35.48 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $134.90 Typical High $245.47 | Professional | 54 · Surgery only | $51.29 | $134.90 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $26.30 Typical High $48.98 | Professional | 55 · Aftercare only | $10.23 | $26.30 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $17.38 Typical High $32.36 | Professional | 56 · Pre-op care only | $6.92 | $17.38 | $32.36 |
Where Missouri sits
The same service costs 4.2 times more in Washington 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· 23rd of 51
$263
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.