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 $870.96 Median $3,715.35 Typical High $8,511.38 | Facility | None | $870.96 | $3,715.35 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $870.96 Typical High $1,380.38 | Professional | None | $257.04 | $870.96 | $1,380.38 |
Ambetter Setting Professional Modifier None Typical Low $147.91 Median $338.84 Typical High $741.31 | Professional | None | $147.91 | $338.84 | $741.31 |
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 $281.84 Median $489.78 Typical High $1,380.38 | Professional | None | $281.84 | $489.78 | $1,380.38 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $426.58 Median $724.44 Typical High $2,041.74 | Professional | 50 · Both sides | $426.58 | $724.44 | $2,041.74 |
BCBS Kansas City Setting Professional Modifier None Typical Low $234.42 Median $758.58 Typical High $1,071.52 | Professional | None | $234.42 | $758.58 | $1,071.52 |
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 $245.47 Median $724.44 Typical High $1,659.59 | Professional | None | $245.47 | $724.44 | $1,659.59 |
Medica Setting Facility Modifier None Typical Low $331.13 Median $1,288.25 Typical High $8,912.51 | Facility | None | $331.13 | $1,288.25 | $8,912.51 |
Medica Setting Professional Modifier None Typical Low $1,288.25 Median $3,162.28 Typical High $7,244.36 | Professional | None | $1,288.25 | $3,162.28 | $7,244.36 |
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 $338.84 Median $891.25 Typical High $1,905.46 | Professional | None | $338.84 | $891.25 | $1,905.46 |
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 $346.74 Typical High $501.19 | Professional | 52 · Reduced service | $128.82 | $346.74 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $141.25 Typical High $199.53 | Professional | 53 · Discontinued | $52.48 | $141.25 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $194.98 Median $524.81 Typical High $758.58 | Professional | 54 · Surgery only | $194.98 | $524.81 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $104.71 Typical High $151.36 | Professional | 55 · Aftercare only | $38.90 | $104.71 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $69.18 Typical High $100.00 | Professional | 56 · Pre-op care only | $25.70 | $69.18 | $100.00 |
Where Missouri sits
The same service costs 4.3 times more in Wisconsin than in Hawaii. 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
$891
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.