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 $316.23 Median $4,570.88 Typical High $9,549.93 | Facility | None | $316.23 | $4,570.88 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $251.19 Typical High $309.03 | Professional | None | $125.89 | $251.19 | $309.03 |
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 $147.91 Median $275.42 Typical High $457.09 | Professional | None | $147.91 | $275.42 | $457.09 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $229.09 Median $398.11 Typical High $676.08 | Professional | 50 · Both sides | $229.09 | $398.11 | $676.08 |
BCBS Kansas City Setting Professional Modifier None Typical Low $123.03 Median $263.03 Typical High $363.08 | Professional | None | $123.03 | $263.03 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $512.86 Typical High $12,589.25 | Facility | None | $213.80 | $512.86 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $263.03 Typical High $524.81 | Professional | None | $131.83 | $263.03 | $524.81 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $660.69 Typical High $16,218.10 | Facility | None | $134.90 | $660.69 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $1,862.09 Typical High $2,041.74 | Professional | None | $295.12 | $1,862.09 | $2,041.74 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $3,388.44 | Facility | None | $123.03 | $602.56 | $3,388.44 |
United Setting Professional Modifier None Typical Low $158.49 Median $288.40 Typical High $501.19 | Professional | None | $158.49 | $288.40 | $501.19 |
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 $61.66 Median $125.89 Typical High $138.04 | Professional | 52 · Reduced service | $61.66 | $125.89 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $50.12 Typical High $54.95 | Professional | 53 · Discontinued | $24.55 | $50.12 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $190.55 Typical High $208.93 | Professional | 54 · Surgery only | $93.33 | $190.55 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $38.02 Typical High $41.69 | Professional | 55 · Aftercare only | $18.62 | $38.02 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $25.12 Typical High $27.54 | Professional | 56 · Pre-op care only | $12.30 | $25.12 | $27.54 |
Where Missouri sits
The same service costs 3.2 times more in Wisconsin 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· 21st of 51
$288
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.