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 $707.95 Median $3,715.35 Typical High $7,762.47 | Facility | None | $707.95 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $1,584.89 Typical High $2,630.27 | Professional | None | $380.19 | $1,584.89 | $2,630.27 |
Ambetter Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $331.13 | Professional | None | $251.19 | $251.19 | $331.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $3,981.07 Typical High $9,549.93 | Facility | None | $2,238.72 | $3,981.07 | $9,549.93 |
Anthem BCBS Setting Professional Modifier None Typical Low $346.74 Median $1,445.44 Typical High $2,511.89 | Professional | None | $346.74 | $1,445.44 | $2,511.89 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $524.81 Median $2,041.74 Typical High $3,801.89 | Professional | 50 · Both sides | $524.81 | $2,041.74 | $3,801.89 |
BCBS Kansas City Setting Professional Modifier None Typical Low $346.74 Median $2,041.74 Typical High $2,884.03 | Professional | None | $346.74 | $2,041.74 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $1,202.26 Typical High $3,467.37 | Professional | None | $354.81 | $1,202.26 | $3,467.37 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,511.89 Typical High $11,748.98 | Facility | None | $54.95 | $2,511.89 | $11,748.98 |
Medica Setting Professional Modifier None Typical Low $2,454.71 Median $7,585.78 Typical High $14,454.40 | Professional | None | $2,454.71 | $7,585.78 | $14,454.40 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $4,677.35 Typical High $14,125.38 | Facility | None | $2,691.53 | $4,677.35 | $14,125.38 |
United Setting Professional Modifier None Typical Low $478.63 Median $1,819.70 Typical High $3,890.45 | Professional | None | $478.63 | $1,819.70 | $3,890.45 |
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 $190.55 Median $724.44 Typical High $1,230.27 | Professional | 52 · Reduced service | $190.55 | $724.44 | $1,230.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $295.12 Typical High $489.78 | Professional | 53 · Discontinued | $75.86 | $295.12 | $489.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $281.84 Median $1,096.48 Typical High $1,862.09 | Professional | 54 · Surgery only | $281.84 | $1,096.48 | $1,862.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $56.23 Median $218.78 Typical High $371.54 | Professional | 55 · Aftercare only | $56.23 | $218.78 | $371.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $147.91 Typical High $245.47 | Professional | 56 · Pre-op care only | $38.02 | $147.91 | $245.47 |
Where Missouri sits
The same service costs 6.2 times more in Washington 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· 27th of 51
$1,778
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.