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 $1,148.15 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,148.15 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $1,096.48 Typical High $1,621.81 | Professional | None | $257.04 | $1,096.48 | $1,621.81 |
Ambetter Setting Professional Modifier None Typical Low $229.09 Median $416.87 Typical High $446.68 | Professional | None | $229.09 | $416.87 | $446.68 |
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 $229.09 Median $933.25 Typical High $1,698.24 | Professional | None | $229.09 | $933.25 | $1,698.24 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $338.84 Median $1,380.38 Typical High $2,570.40 | Professional | 50 · Both sides | $338.84 | $1,380.38 | $2,570.40 |
BCBS Kansas City Setting Professional Modifier None Typical Low $234.42 Median $1,380.38 Typical High $1,949.84 | Professional | None | $234.42 | $1,380.38 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $831.76 Typical High $2,238.72 | Professional | None | $239.88 | $831.76 | $2,238.72 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $870.96 Typical High $2,398.83 | Facility | None | $54.95 | $870.96 | $2,398.83 |
Medica Setting Professional Modifier None Typical Low $1,698.24 Median $4,897.79 Typical High $9,332.54 | Professional | None | $1,698.24 | $4,897.79 | $9,332.54 |
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 $316.23 Median $1,230.27 Typical High $2,630.27 | Professional | None | $316.23 | $1,230.27 | $2,630.27 |
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 $128.82 Median $501.19 Typical High $812.83 | Professional | 52 · Reduced service | $128.82 | $501.19 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $199.53 Typical High $323.59 | Professional | 53 · Discontinued | $51.29 | $199.53 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $758.58 Typical High $1,230.27 | Professional | 54 · Surgery only | $190.55 | $758.58 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $151.36 Typical High $245.47 | Professional | 55 · Aftercare only | $38.02 | $151.36 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $100.00 Typical High $162.18 | Professional | 56 · Pre-op care only | $25.70 | $100.00 | $162.18 |
Where Missouri sits
The same service costs 6.5 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· 24th of 51
$1,230
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.