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 $63.10 Median $1,819.70 Typical High $6,309.57 | Facility | None | $63.10 | $1,819.70 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $107.15 Typical High $213.80 | Professional | None | $52.48 | $107.15 | $213.80 |
Ambetter Setting Professional Modifier None Typical Low $44.67 Median $75.86 Typical High $186.21 | Professional | None | $44.67 | $75.86 | $186.21 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $1,621.81 Typical High $3,890.45 | Facility | None | $151.36 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $89.13 Typical High $117.49 | Professional | None | $60.26 | $89.13 | $117.49 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $89.13 Median $131.83 Typical High $173.78 | Professional | 50 · Both sides | $89.13 | $131.83 | $173.78 |
BCBS Kansas City Setting Professional Modifier None Typical Low $52.48 Median $112.20 Typical High $218.78 | Professional | None | $52.48 | $112.20 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $66.07 | Facility | None | $50.12 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $138.04 Typical High $281.84 | Professional | None | $54.95 | $138.04 | $281.84 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $269.15 Typical High $1,288.25 | Facility | None | $54.95 | $269.15 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $120.23 Median $602.56 Typical High $1,148.15 | Professional | None | $120.23 | $602.56 | $1,148.15 |
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 $67.61 Median $117.49 Typical High $275.42 | Professional | None | $67.61 | $117.49 | $275.42 |
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 $26.30 Median $50.12 Typical High $77.62 | Professional | 52 · Reduced service | $26.30 | $50.12 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $19.95 Typical High $30.90 | Professional | 53 · Discontinued | $10.47 | $19.95 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $75.86 Typical High $114.82 | Professional | 54 · Surgery only | $38.90 | $75.86 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $15.14 Typical High $23.44 | Professional | 55 · Aftercare only | $7.76 | $15.14 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $10.00 Typical High $15.49 | Professional | 56 · Pre-op care only | $5.25 | $10.00 | $15.49 |
Where Missouri sits
The same service costs 4.0 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· 33rd of 51
$123
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.