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 $1,348.96 Median $3,715.35 Typical High $7,762.47 | Facility | None | $1,348.96 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $1,258.93 Typical High $1,659.59 | Professional | None | $263.03 | $1,258.93 | $1,659.59 |
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 $281.84 Median $1,071.52 Typical High $1,905.46 | Professional | None | $281.84 | $1,071.52 | $1,905.46 |
BCBS Kansas City Setting Professional Modifier None Typical Low $239.88 Median $1,148.15 Typical High $1,621.81 | Professional | None | $239.88 | $1,148.15 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $831.76 Typical High $2,344.23 | Professional | None | $245.47 | $831.76 | $2,344.23 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,995.26 Typical High $6,606.93 | Facility | None | $54.95 | $1,995.26 | $6,606.93 |
Medica Setting Professional Modifier None Typical Low $2,041.74 Median $4,786.30 Typical High $9,332.54 | Professional | None | $2,041.74 | $4,786.30 | $9,332.54 |
United Setting Facility Modifier None Typical Low $1,862.09 Median $3,981.07 Typical High $8,317.64 | Facility | None | $1,862.09 | $3,981.07 | $8,317.64 |
United Setting Professional Modifier None Typical Low $371.54 Median $1,258.93 Typical High $2,818.38 | Professional | None | $371.54 | $1,258.93 | $2,818.38 |
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 $131.83 Median $575.44 Typical High $776.25 | Professional | 52 · Reduced service | $131.83 | $575.44 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $234.42 Typical High $309.03 | Professional | 53 · Discontinued | $52.48 | $234.42 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $870.96 Typical High $1,148.15 | Professional | 54 · Surgery only | $199.53 | $870.96 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $173.78 Typical High $234.42 | Professional | 55 · Aftercare only | $39.81 | $173.78 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $114.82 Typical High $154.88 | Professional | 56 · Pre-op care only | $26.30 | $114.82 | $154.88 |
Where Missouri sits
The same service costs 4.7 times more in Wisconsin 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
$1,445
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.