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 $1,380.38 Median $3,715.35 Typical High $6,309.57 | Facility | None | $1,380.38 | $3,715.35 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $1,348.96 Typical High $2,041.74 | Professional | None | $123.03 | $1,348.96 | $2,041.74 |
Ambetter Setting Professional Modifier None Typical Low $1,047.13 Median $1,348.96 Typical High $1,659.59 | Professional | None | $1,047.13 | $1,348.96 | $1,659.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $1,621.81 Typical High $3,890.45 | Facility | None | $151.36 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $501.19 Typical High $2,041.74 | Professional | None | $120.23 | $501.19 | $2,041.74 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $181.97 Median $724.44 Typical High $3,019.95 | Professional | 50 · Both sides | $181.97 | $724.44 | $3,019.95 |
BCBS Kansas City Setting Professional Modifier None Typical Low $109.65 Median $1,230.27 Typical High $1,737.80 | Professional | None | $109.65 | $1,230.27 | $1,737.80 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,445.44 Typical High $6,760.83 | Facility | None | $707.95 | $1,445.44 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $295.12 Typical High $2,691.53 | Professional | None | $114.82 | $295.12 | $2,691.53 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,174.90 Typical High $3,235.94 | Facility | None | $54.95 | $1,174.90 | $3,235.94 |
Medica Setting Professional Modifier None Typical Low $2,137.96 Median $4,570.88 Typical High $9,332.54 | Professional | None | $2,137.96 | $4,570.88 | $9,332.54 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,235.94 | Facility | None | $562.34 | $1,513.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $169.82 Median $1,174.90 Typical High $3,388.44 | Professional | None | $169.82 | $1,174.90 | $3,388.44 |
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 $61.66 Median $100.00 Typical High $794.33 | Professional | 52 · Reduced service | $61.66 | $100.00 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $39.81 Typical High $316.23 | Professional | 53 · Discontinued | $24.55 | $39.81 | $316.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $151.36 Typical High $1,174.90 | Professional | 54 · Surgery only | $93.33 | $151.36 | $1,174.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $30.20 Typical High $234.42 | Professional | 55 · Aftercare only | $18.62 | $30.20 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $19.95 Typical High $158.49 | Professional | 56 · Pre-op care only | $12.30 | $19.95 | $158.49 |
Where Missouri sits
The same service costs 10.5 times more in Alaska 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· 21st of 51
$1,380
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.