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 $229.09 Median $3,235.94 Typical High $8,511.38 | Facility | None | $229.09 | $3,235.94 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $229.09 Typical High $380.19 | Professional | None | $158.49 | $229.09 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $95.50 Typical High $338.84 | Professional | None | $74.13 | $95.50 | $338.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,445.44 Median $3,801.89 Typical High $10,471.29 | Facility | None | $1,445.44 | $3,801.89 | $10,471.29 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $302.00 Typical High $426.58 | Professional | None | $190.55 | $302.00 | $426.58 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $288.40 Median $457.09 Typical High $645.65 | Professional | 50 · Both sides | $288.40 | $457.09 | $645.65 |
BCBS Kansas City Setting Professional Modifier None Typical Low $151.36 Median $257.04 Typical High $346.74 | Professional | None | $151.36 | $257.04 | $346.74 |
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 $162.18 Median $257.04 Typical High $512.86 | Professional | None | $162.18 | $257.04 | $512.86 |
Medica Setting Facility Modifier None Typical Low $426.58 Median $1,445.44 Typical High $12,022.64 | Facility | None | $426.58 | $1,445.44 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $2,187.76 Typical High $2,187.76 | Professional | None | $323.59 | $2,187.76 | $2,187.76 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,548.82 Typical High $4,897.79 | Facility | None | $562.34 | $1,548.82 | $4,897.79 |
United Setting Professional Modifier None Typical Low $213.80 Median $316.23 Typical High $489.78 | Professional | None | $213.80 | $316.23 | $489.78 |
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 $75.86 Median $114.82 Typical High $128.82 | Professional | 52 · Reduced service | $75.86 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $45.71 Typical High $51.29 | Professional | 53 · Discontinued | $30.90 | $45.71 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $173.78 Typical High $190.55 | Professional | 54 · Surgery only | $114.82 | $173.78 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $34.67 Typical High $38.90 | Professional | 55 · Aftercare only | $22.91 | $34.67 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $22.91 Typical High $25.70 | Professional | 56 · Pre-op care only | $15.14 | $22.91 | $25.70 |
Where Missouri sits
The same service costs 3.1 times more in Alaska than in New York. 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· 20th of 51
$355
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.