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 $257.04 Median $3,162.28 Typical High $7,762.47 | Facility | None | $257.04 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $208.93 Typical High $275.42 | Professional | None | $131.83 | $208.93 | $275.42 |
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 $165.96 Median $194.98 Typical High $263.03 | Professional | None | $165.96 | $194.98 | $263.03 |
BCBS Kansas City Setting Professional Modifier None Typical Low $154.88 Median $269.15 Typical High $346.74 | Professional | None | $154.88 | $269.15 | $346.74 |
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 $131.83 Median $223.87 Typical High $389.05 | Professional | None | $131.83 | $223.87 | $389.05 |
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 $1,174.90 Typical High $1,862.09 | Professional | None | $257.04 | $1,174.90 | $1,862.09 |
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 $158.49 Median $245.47 Typical High $380.19 | Professional | None | $158.49 | $245.47 | $380.19 |
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 $66.07 Median $104.71 Typical High $128.82 | Professional | 52 · Reduced service | $66.07 | $104.71 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $41.69 Typical High $51.29 | Professional | 53 · Discontinued | $26.30 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $158.49 Typical High $194.98 | Professional | 54 · Surgery only | $100.00 | $158.49 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $31.62 Typical High $38.90 | Professional | 55 · Aftercare only | $19.95 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $20.89 Typical High $25.70 | Professional | 56 · Pre-op care only | $13.18 | $20.89 | $25.70 |
Where Missouri sits
The same service costs 3.9 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· 38th of 51
$234
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.