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 $1,548.82 Median $3,715.35 Typical High $6,309.57 | Facility | None | $1,548.82 | $3,715.35 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $1,862.09 Typical High $2,570.40 | Professional | None | $363.08 | $1,862.09 | $2,570.40 |
Ambetter Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
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 $380.19 Median $1,621.81 Typical High $2,951.21 | Professional | None | $380.19 | $1,621.81 | $2,951.21 |
BCBS Kansas City Setting Professional Modifier None Typical Low $323.59 Median $1,778.28 Typical High $2,570.40 | Professional | None | $323.59 | $1,778.28 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $1,148.15 Typical High $3,715.35 | Professional | None | $338.84 | $1,148.15 | $3,715.35 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,884.03 Typical High $11,748.98 | Facility | None | $54.95 | $2,884.03 | $11,748.98 |
Medica Setting Professional Modifier None Typical Low $3,162.28 Median $7,413.10 Typical High $14,454.40 | Professional | None | $3,162.28 | $7,413.10 | $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 $512.86 Median $1,949.84 Typical High $4,466.84 | Professional | None | $512.86 | $1,949.84 | $4,466.84 |
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 $181.97 Median $831.76 Typical High $1,202.26 | Professional | 52 · Reduced service | $181.97 | $831.76 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $331.13 Typical High $478.63 | Professional | 53 · Discontinued | $72.44 | $331.13 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $1,230.27 Typical High $1,819.70 | Professional | 54 · Surgery only | $275.42 | $1,230.27 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $245.47 Typical High $363.08 | Professional | 55 · Aftercare only | $54.95 | $245.47 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $165.96 Typical High $239.88 | Professional | 56 · Pre-op care only | $36.31 | $165.96 | $239.88 |
Where Missouri sits
The same service costs 6.9 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
$2,239
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.