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 $114.82 Median $4,677.35 Typical High $7,762.47 | Facility | None | $114.82 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $128.82 | Professional | None | $83.18 | $114.82 | $128.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,479.11 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $213.80 | Professional | None | $104.71 | $144.54 | $213.80 |
BCBS Kansas City Setting Professional Modifier None Typical Low $85.11 Median $138.04 Typical High $186.21 | Professional | None | $85.11 | $138.04 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $457.09 Typical High $1,659.59 | Facility | None | $338.84 | $457.09 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $134.90 Typical High $302.00 | Professional | None | $87.10 | $134.90 | $302.00 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $676.08 Typical High $1,905.46 | Facility | None | $54.95 | $676.08 | $1,905.46 |
Medica Setting Professional Modifier None Typical Low $154.88 Median $676.08 Typical High $954.99 | Professional | None | $154.88 | $676.08 | $954.99 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $2,238.72 | Facility | None | $398.11 | $1,148.15 | $2,238.72 |
United Setting Professional Modifier None Typical Low $114.82 Median $158.49 Typical High $263.03 | Professional | None | $114.82 | $158.49 | $263.03 |
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 $41.69 Median $57.54 Typical High $64.57 | Professional | 52 · Reduced service | $41.69 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $22.91 Typical High $25.70 | Professional | 53 · Discontinued | $16.60 | $22.91 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $87.10 Typical High $97.72 | Professional | 54 · Surgery only | $61.66 | $87.10 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $17.38 Typical High $19.50 | Professional | 55 · Aftercare only | $12.59 | $17.38 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $11.48 Typical High $12.88 | Professional | 56 · Pre-op care only | $8.32 | $11.48 | $12.88 |
Where Missouri sits
The same service costs 3.5 times more in Alaska than in Indiana. 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· 30th of 51
$158
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.