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 $64.57 Median $4,677.35 Typical High $7,762.47 | Facility | None | $64.57 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $64.57 Typical High $85.11 | Professional | None | $41.69 | $64.57 | $85.11 |
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 $50.12 Median $66.07 Typical High $85.11 | Professional | None | $50.12 | $66.07 | $85.11 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $74.13 Median $95.50 Typical High $120.23 | Professional | 50 · Both sides | $74.13 | $95.50 | $120.23 |
BCBS Kansas City Setting Professional Modifier None Typical Low $46.77 Median $79.43 Typical High $100.00 | Professional | None | $46.77 | $79.43 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $66.07 Typical High $91.20 | Facility | None | $54.95 | $66.07 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $75.86 Typical High $123.03 | Professional | None | $46.77 | $75.86 | $123.03 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $234.42 Typical High $1,288.25 | Facility | None | $54.95 | $234.42 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $79.43 Median $371.54 Typical High $588.84 | Professional | None | $79.43 | $371.54 | $588.84 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $2,137.96 | Facility | None | $123.03 | $537.03 | $2,137.96 |
United Setting Professional Modifier None Typical Low $50.12 Median $77.62 Typical High $120.23 | Professional | None | $50.12 | $77.62 | $120.23 |
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 $32.36 Typical High $39.81 | Professional | 52 · Reduced service | $20.89 | $32.36 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $12.88 Typical High $15.85 | Professional | 53 · Discontinued | $8.32 | $12.88 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $47.86 Typical High $60.26 | Professional | 54 · Surgery only | $30.90 | $47.86 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $9.77 Typical High $12.02 | Professional | 55 · Aftercare only | $6.17 | $9.77 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $6.46 Typical High $7.94 | Professional | 56 · Pre-op care only | $4.17 | $6.46 | $7.94 |
Where Missouri sits
The same service costs 3.6 times more in Alaska than in Kentucky. 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· 30th of 51
$79.43
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.