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 $9.55 Median $14.45 Typical High $42.66 | Facility | None | $9.55 | $14.45 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $22.39 Typical High $38.90 | Professional | None | $9.55 | $22.39 | $38.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,709.64 Median $10,232.93 Typical High $12,882.50 | Facility | None | $8,709.64 | $10,232.93 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.72 Median $25.12 Typical High $45.71 | Professional | None | $10.72 | $25.12 | $45.71 |
BCBS Kansas City Setting Professional Modifier None Typical Low $8.32 Median $28.84 Typical High $41.69 | Professional | None | $8.32 | $28.84 | $41.69 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $2,691.53 Typical High $2,691.53 | Facility | None | $1,096.48 | $2,691.53 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $8.91 Median $27.54 Typical High $58.88 | Professional | None | $8.91 | $27.54 | $58.88 |
Medica Setting Facility Modifier None Typical Low $38.02 Median $173.78 Typical High $1,258.93 | Facility | None | $38.02 | $173.78 | $1,258.93 |
Medica Setting Professional Modifier None Typical Low $36.31 Median $181.97 Typical High $338.84 | Professional | None | $36.31 | $181.97 | $338.84 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $2,137.96 | Facility | None | $123.03 | $549.54 | $2,137.96 |
United Setting Professional Modifier None Typical Low $12.88 Median $30.20 Typical High $66.07 | Professional | None | $12.88 | $30.20 | $66.07 |
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 $4.79 Median $7.94 Typical High $19.50 | Professional | 52 · Reduced service | $4.79 | $7.94 | $19.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $3.16 Typical High $7.76 | Professional | 53 · Discontinued | $1.91 | $3.16 | $7.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $7.24 Median $11.75 Typical High $29.51 | Professional | 54 · Surgery only | $7.24 | $11.75 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $2.34 Typical High $5.89 | Professional | 55 · Aftercare only | $1.45 | $2.34 | $5.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $1.58 Typical High $3.89 | Professional | 56 · Pre-op care only | $0.95 | $1.58 | $3.89 |
Where Missouri sits
The same service costs 4.2 times more in Wisconsin than in Nebraska. 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
$30.20
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.