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 $16.22 Median $32.36 Typical High $7,762.47 | Facility | None | $16.22 | $32.36 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $28.84 Typical High $34.67 | Professional | None | $15.49 | $28.84 | $34.67 |
Ambetter Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,709.64 Median $10,232.93 Typical High $12,882.50 | Facility | None | $8,709.64 | $10,232.93 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.60 Median $32.36 Typical High $51.29 | Professional | None | $16.60 | $32.36 | $51.29 |
BCBS Kansas City Setting Professional Modifier None Typical Low $13.80 Median $26.92 Typical High $37.15 | Professional | None | $13.80 | $26.92 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $66.07 | Facility | None | $50.12 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $26.30 Typical High $61.66 | Professional | None | $14.45 | $26.30 | $61.66 |
Medica Setting Facility Modifier None Typical Low $27.54 Median $114.82 Typical High $1,096.48 | Facility | None | $27.54 | $114.82 | $1,096.48 |
Medica Setting Professional Modifier None Typical Low $40.74 Median $138.04 Typical High $204.17 | Professional | None | $40.74 | $138.04 | $204.17 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $5,011.87 | Facility | None | $123.03 | $537.03 | $5,011.87 |
United Setting Professional Modifier None Typical Low $21.88 Median $38.90 Typical High $69.18 | Professional | None | $21.88 | $38.90 | $69.18 |
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 $7.76 Median $12.88 Typical High $17.38 | Professional | 52 · Reduced service | $7.76 | $12.88 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $5.25 Typical High $6.92 | Professional | 53 · Discontinued | $3.16 | $5.25 | $6.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $11.75 Median $19.50 Typical High $26.30 | Professional | 54 · Surgery only | $11.75 | $19.50 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.34 Median $3.89 Typical High $5.25 | Professional | 55 · Aftercare only | $2.34 | $3.89 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $2.57 Typical High $3.47 | Professional | 56 · Pre-op care only | $1.55 | $2.57 | $3.47 |
Where Missouri sits
The same service costs 3.5 times more in Wisconsin than in Kentucky. 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· 32nd of 51
$33.88
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.