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 $524.81 Median $3,715.35 Typical High $8,511.38 | Facility | None | $524.81 | $3,715.35 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $1,096.48 Typical High $1,445.44 | Professional | None | $281.84 | $1,096.48 | $1,445.44 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $194.98 Typical High $316.23 | Professional | None | $158.49 | $194.98 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,344.23 Median $4,570.88 Typical High $11,748.98 | Facility | None | $2,344.23 | $4,570.88 | $11,748.98 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $489.78 Typical High $1,621.81 | Professional | None | $302.00 | $489.78 | $1,621.81 |
BCBS Kansas City Setting Professional Modifier None Typical Low $257.04 Median $1,023.29 Typical High $1,445.44 | Professional | None | $257.04 | $1,023.29 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $8,511.38 Median $16,982.44 Typical High $26,915.35 | Facility | None | $8,511.38 | $16,982.44 | $26,915.35 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $851.14 Typical High $1,949.84 | Professional | None | $263.03 | $851.14 | $1,949.84 |
Medica Setting Facility Modifier None Typical Low $346.74 Median $1,348.96 Typical High $8,912.51 | Facility | None | $346.74 | $1,348.96 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $1,698.24 Median $3,981.07 Typical High $7,762.47 | Professional | None | $1,698.24 | $3,981.07 | $7,762.47 |
United Setting Facility Modifier None Typical Low $331.13 Median $912.01 Typical High $13,489.63 | Facility | None | $331.13 | $912.01 | $13,489.63 |
United Setting Professional Modifier None Typical Low $354.81 Median $1,071.52 Typical High $2,290.87 | Professional | None | $354.81 | $1,071.52 | $2,290.87 |
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 $141.25 Median $457.09 Typical High $645.65 | Professional | 52 · Reduced service | $141.25 | $457.09 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $186.21 Typical High $257.04 | Professional | 53 · Discontinued | $56.23 | $186.21 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $691.83 Typical High $977.24 | Professional | 54 · Surgery only | $208.93 | $691.83 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $138.04 Typical High $194.98 | Professional | 55 · Aftercare only | $41.69 | $138.04 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $93.33 Typical High $128.82 | Professional | 56 · Pre-op care only | $28.18 | $93.33 | $128.82 |
Where Missouri sits
The same service costs 3.5 times more in Wisconsin than in Maryland. 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· 14th of 51
$1,148
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.