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 $89.13 Median $117.49 Typical High $181.97 | Facility | None | $89.13 | $117.49 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $117.49 Typical High $158.49 | Professional | None | $89.13 | $117.49 | $158.49 |
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 $107.15 Median $131.83 Typical High $181.97 | Professional | None | $107.15 | $131.83 | $181.97 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $162.18 Median $194.98 Typical High $269.15 | Professional | 50 · Both sides | $162.18 | $194.98 | $269.15 |
BCBS Kansas City Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $190.55 | Professional | None | $100.00 | $151.36 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $100.00 Typical High $141.25 | Facility | None | $58.88 | $100.00 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $147.91 Typical High $239.88 | Professional | None | $97.72 | $147.91 | $239.88 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $309.03 Typical High $1,288.25 | Facility | None | $54.95 | $309.03 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $776.25 Typical High $1,071.52 | Professional | None | $151.36 | $776.25 | $1,071.52 |
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 $109.65 Median $158.49 Typical High $239.88 | Professional | None | $109.65 | $158.49 | $239.88 |
4 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 $44.67 Median $60.26 Typical High $74.13 | Professional | 52 · Reduced service | $44.67 | $60.26 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $23.99 Typical High $29.51 | Professional | 53 · Discontinued | $17.78 | $23.99 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $18.20 Typical High $22.39 | Professional | 55 · Aftercare only | $13.49 | $18.20 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $12.02 Typical High $14.79 | Professional | 56 · Pre-op care only | $8.91 | $12.02 | $14.79 |
Where Missouri sits
The same service costs 4.0 times more in Alaska than in Florida. 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
$155
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.