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 $131.83 Median $141.25 Typical High $162.18 | Professional | None | $131.83 | $141.25 | $162.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $128.82 Median $162.18 Typical High $269.15 | Professional | None | $128.82 | $162.18 | $269.15 |
BCBS Kansas City Setting Professional Modifier None Typical Low $117.49 Median $128.82 Typical High $177.83 | Professional | None | $117.49 | $128.82 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $363.08 Typical High $1,659.59 | Facility | None | $239.88 | $363.08 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $239.88 | Professional | None | $120.23 | $141.25 | $239.88 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $331.13 Typical High $1,348.96 | Facility | None | $54.95 | $331.13 | $1,348.96 |
Medica Setting Professional Modifier None Typical Low $165.96 Median $1,737.80 Typical High $1,737.80 | Professional | None | $165.96 | $1,737.80 | $1,737.80 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,137.96 | Facility | None | $123.03 | $602.56 | $2,137.96 |
United Setting Professional Modifier None Typical Low $120.23 Median $186.21 Typical High $257.04 | Professional | None | $120.23 | $186.21 | $257.04 |
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 $64.57 Median $67.61 Typical High $81.28 | Professional | 52 · Reduced service | $64.57 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $26.92 Typical High $32.36 | Professional | 53 · Discontinued | $26.30 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $100.00 Typical High $120.23 | Professional | 54 · Surgery only | $97.72 | $100.00 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.95 Typical High $23.99 | Professional | 55 · Aftercare only | $19.50 | $19.95 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.49 Typical High $16.22 | Professional | 56 · Pre-op care only | $13.18 | $13.49 | $16.22 |
Where Missouri sits
The same service costs 5.1 times more in Alaska than in Utah. 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
$170
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.