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 $91.20 Median $2,570.40 Typical High $6,309.57 | Facility | None | $91.20 | $2,570.40 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $263.03 Typical High $416.87 | Professional | None | $50.12 | $263.03 | $416.87 |
Ambetter Setting Professional Modifier None Typical Low $40.74 Median $54.95 Typical High $54.95 | Professional | None | $40.74 | $54.95 | $54.95 |
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 $52.48 Median $91.20 Typical High $436.52 | Professional | None | $52.48 | $91.20 | $436.52 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $77.62 Median $138.04 Typical High $645.65 | Professional | 50 · Both sides | $77.62 | $138.04 | $645.65 |
BCBS Kansas City Setting Professional Modifier None Typical Low $43.65 Median $229.09 Typical High $331.13 | Professional | None | $43.65 | $229.09 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $186.21 Typical High $512.86 | Professional | None | $45.71 | $186.21 | $512.86 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $446.68 Typical High $1,230.27 | Facility | None | $54.95 | $446.68 | $1,230.27 |
Medica Setting Professional Modifier None Typical Low $436.52 Median $933.25 Typical High $2,290.87 | Professional | None | $436.52 | $933.25 | $2,290.87 |
United Setting Facility Modifier None Typical Low $245.47 Median $870.96 Typical High $3,548.13 | Facility | None | $245.47 | $870.96 | $3,548.13 |
United Setting Professional Modifier None Typical Low $64.57 Median $257.04 Typical High $588.84 | Professional | None | $64.57 | $257.04 | $588.84 |
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 $25.12 Median $114.82 Typical High $154.88 | Professional | 52 · Reduced service | $25.12 | $114.82 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $45.71 Typical High $61.66 | Professional | 53 · Discontinued | $10.00 | $45.71 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $173.78 Typical High $229.09 | Professional | 54 · Surgery only | $37.15 | $173.78 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $34.67 Typical High $46.77 | Professional | 55 · Aftercare only | $7.41 | $34.67 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $22.91 Typical High $30.90 | Professional | 56 · Pre-op care only | $5.01 | $22.91 | $30.90 |
Where Missouri sits
The same service costs 4.9 times more in Iowa 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· 15th of 51
$295
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.