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 $102.33 Median $109.65 Typical High $125.89 | Professional | None | $102.33 | $109.65 | $125.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $114.82 Typical High $158.49 | Professional | None | $97.72 | $114.82 | $158.49 |
BCBS Kansas City Setting Professional Modifier None Typical Low $85.11 Median $93.33 Typical High $141.25 | Professional | None | $85.11 | $93.33 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,513.56 Typical High $1,659.59 | Facility | None | $575.44 | $1,513.56 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $213.80 | Professional | None | $91.20 | $114.82 | $213.80 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $281.84 Typical High $1,288.25 | Facility | None | $54.95 | $281.84 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $223.87 Typical High $724.44 | Professional | None | $134.90 | $223.87 | $724.44 |
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 $95.50 Median $158.49 Typical High $204.17 | Professional | None | $95.50 | $158.49 | $204.17 |
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 $51.29 Median $52.48 Typical High $61.66 | Professional | 52 · Reduced service | $51.29 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.89 Typical High $25.12 | Professional | 53 · Discontinued | $20.42 | $20.89 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $79.43 Typical High $93.33 | Professional | 54 · Surgery only | $75.86 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.85 Typical High $18.62 | Professional | 55 · Aftercare only | $15.14 | $15.85 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.47 Typical High $12.59 | Professional | 56 · Pre-op care only | $10.23 | $10.47 | $12.59 |
Where Missouri sits
The same service costs 4.0 times more in Alaska than in Florida. 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· 36th of 51
$120
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.