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 $245.47 Median $4,677.35 Typical High $7,762.47 | Facility | None | $245.47 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $245.47 Typical High $323.59 | Professional | None | $144.54 | $245.47 | $323.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $204.17 Median $3,467.37 Typical High $7,079.46 | Facility | None | $204.17 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $169.82 Median $213.80 Typical High $281.84 | Professional | None | $169.82 | $213.80 | $281.84 |
BCBS Kansas City Setting Professional Modifier None Typical Low $165.96 Median $323.59 Typical High $407.38 | Professional | None | $165.96 | $323.59 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $158.49 Typical High $229.09 | Facility | None | $58.88 | $158.49 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $251.19 Typical High $436.52 | Professional | None | $144.54 | $251.19 | $436.52 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $338.84 Typical High $1,288.25 | Facility | None | $54.95 | $338.84 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $1,288.25 Typical High $2,238.72 | Professional | None | $257.04 | $1,288.25 | $2,238.72 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,137.96 | Facility | None | $123.03 | $602.56 | $2,137.96 |
United Setting Professional Modifier None Typical Low $165.96 Median $257.04 Typical High $446.68 | Professional | None | $165.96 | $257.04 | $446.68 |
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 $72.44 Median $123.03 Typical High $154.88 | Professional | 52 · Reduced service | $72.44 | $123.03 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $50.12 Typical High $61.66 | Professional | 53 · Discontinued | $28.84 | $50.12 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $186.21 Typical High $229.09 | Professional | 54 · Surgery only | $109.65 | $186.21 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $37.15 Typical High $45.71 | Professional | 55 · Aftercare only | $21.88 | $37.15 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $24.55 Typical High $30.90 | Professional | 56 · Pre-op care only | $14.45 | $24.55 | $30.90 |
Where Missouri sits
The same service costs 4.0 times more in Alaska than in Maryland. 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· 35th of 51
$251
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.