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 $363.08 Median $4,570.88 Typical High $9,549.93 | Facility | None | $363.08 | $4,570.88 | $9,549.93 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $281.84 Typical High $338.84 | Professional | None | $144.54 | $281.84 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $181.97 Median $288.40 Typical High $512.86 | Professional | None | $181.97 | $288.40 | $512.86 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $263.03 Median $436.52 Typical High $776.25 | Professional | 50 · Both sides | $263.03 | $436.52 | $776.25 |
BCBS Kansas City Setting Professional Modifier None Typical Low $144.54 Median $302.00 Typical High $416.87 | Professional | None | $144.54 | $302.00 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,202.26 Typical High $12,589.25 | Facility | None | $524.81 | $1,202.26 | $12,589.25 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $302.00 Typical High $602.56 | Professional | None | $154.88 | $302.00 | $602.56 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $1,445.44 Typical High $12,022.64 | Facility | None | $380.19 | $1,445.44 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $338.84 Median $1,995.26 Typical High $2,290.87 | Professional | None | $338.84 | $1,995.26 | $2,290.87 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,311.31 | Facility | None | $562.34 | $1,513.56 | $3,311.31 |
United Setting Professional Modifier None Typical Low $186.21 Median $331.13 Typical High $575.44 | Professional | None | $186.21 | $331.13 | $575.44 |
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 $72.44 Median $141.25 Typical High $158.49 | Professional | 52 · Reduced service | $72.44 | $141.25 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $57.54 Typical High $63.10 | Professional | 53 · Discontinued | $28.84 | $57.54 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $213.80 Typical High $239.88 | Professional | 54 · Surgery only | $109.65 | $213.80 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $42.66 Typical High $47.86 | Professional | 55 · Aftercare only | $21.88 | $42.66 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $28.18 Typical High $31.62 | Professional | 56 · Pre-op care only | $14.45 | $28.18 | $31.62 |
Where Missouri sits
The same service costs 3.9 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· 31st of 51
$331
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.