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 $275.42 Median $3,715.35 Typical High $6,309.57 | Facility | None | $275.42 | $3,715.35 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $251.19 Typical High $295.12 | Professional | None | $123.03 | $251.19 | $295.12 |
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 $151.36 Median $281.84 Typical High $446.68 | Professional | None | $151.36 | $281.84 | $446.68 |
BCBS Kansas City Setting Professional Modifier None Typical Low $123.03 Median $269.15 Typical High $371.54 | Professional | None | $123.03 | $269.15 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $316.23 Typical High $2,187.76 | Facility | None | $213.80 | $316.23 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $263.03 Typical High $537.03 | Professional | None | $131.83 | $263.03 | $537.03 |
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 $288.40 Median $2,089.30 Typical High $2,344.23 | Professional | None | $288.40 | $2,089.30 | $2,344.23 |
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 $165.96 Median $281.84 Typical High $537.03 | Professional | None | $165.96 | $281.84 | $537.03 |
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 $134.90 | Professional | 52 · Reduced service | $61.66 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $51.29 Typical High $54.95 | Professional | 53 · Discontinued | $24.55 | $51.29 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $190.55 Typical High $204.17 | Professional | 54 · Surgery only | $91.20 | $190.55 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $38.02 Typical High $40.74 | Professional | 55 · Aftercare only | $18.62 | $38.02 | $40.74 |
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 3.1 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· 19th of 51
$302
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.