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 $1,778.28 Median $5,495.41 Typical High $8,912.51 | Facility | None | $1,778.28 | $5,495.41 | $8,912.51 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $165.96 Typical High $2,511.89 | Professional | None | $144.54 | $165.96 | $2,511.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,981.07 | Facility | None | $446.68 | $1,621.81 | $3,981.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $147.91 Median $213.80 Typical High $346.74 | Professional | None | $147.91 | $213.80 | $346.74 |
BCBS Kansas City Setting Professional Modifier None Typical Low $125.89 Median $134.90 Typical High $181.97 | Professional | None | $125.89 | $134.90 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $3,162.28 Typical High $4,570.88 | Facility | None | $645.65 | $3,162.28 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $194.98 Typical High $346.74 | Professional | None | $131.83 | $194.98 | $346.74 |
Medica Setting Facility Modifier None Typical Low $602.56 Median $5,011.87 Typical High $26,302.68 | Facility | None | $602.56 | $5,011.87 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $380.19 Typical High $1,698.24 | Professional | None | $194.98 | $380.19 | $1,698.24 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,570.88 Typical High $11,748.98 | Facility | None | $977.24 | $4,570.88 | $11,748.98 |
United Setting Professional Modifier None Typical Low $154.88 Median $251.19 Typical High $416.87 | Professional | None | $154.88 | $251.19 | $416.87 |
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 $72.44 Median $83.18 Typical High $89.13 | Professional | 52 · Reduced service | $72.44 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $33.88 Typical High $35.48 | Professional | 53 · Discontinued | $28.84 | $33.88 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $125.89 Typical High $134.90 | Professional | 54 · Surgery only | $109.65 | $125.89 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $25.12 Typical High $26.92 | Professional | 55 · Aftercare only | $21.88 | $25.12 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $16.60 Typical High $17.78 | Professional | 56 · Pre-op care only | $14.45 | $16.60 | $17.78 |
Where Missouri sits
The same service costs 20.4 times more in Kansas than in New York. 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· 19th of 51
$347
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.