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 $323.59 Median $2,570.40 Typical High $6,309.57 | Facility | None | $323.59 | $2,570.40 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $524.81 Typical High $891.25 | Professional | None | $173.78 | $524.81 | $891.25 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $190.55 Typical High $616.60 | Professional | None | $134.90 | $190.55 | $616.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $1,621.81 Typical High $3,981.07 | Facility | None | $151.36 | $1,621.81 | $3,981.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $489.78 Typical High $933.25 | Professional | None | $158.49 | $489.78 | $933.25 |
BCBS Kansas City Setting Professional Modifier None Typical Low $154.88 Median $616.60 Typical High $870.96 | Professional | None | $154.88 | $616.60 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $741.31 Typical High $1,148.15 | Facility | None | $549.54 | $741.31 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $426.58 Typical High $1,148.15 | Professional | None | $162.18 | $426.58 | $1,148.15 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,096.48 Typical High $3,019.95 | Facility | None | $54.95 | $1,096.48 | $3,019.95 |
Medica Setting Professional Modifier None Typical Low $776.25 Median $2,630.27 Typical High $5,128.61 | Professional | None | $776.25 | $2,630.27 | $5,128.61 |
Qualchoice Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
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 $208.93 Median $676.08 Typical High $1,412.54 | Professional | None | $208.93 | $676.08 | $1,412.54 |
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 $87.10 Median $239.88 Typical High $426.58 | Professional | 52 · Reduced service | $87.10 | $239.88 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $95.50 Typical High $169.82 | Professional | 53 · Discontinued | $34.67 | $95.50 | $169.82 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $363.08 Typical High $645.65 | Professional | 54 · Surgery only | $131.83 | $363.08 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $72.44 Typical High $128.82 | Professional | 55 · Aftercare only | $26.30 | $72.44 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $47.86 Typical High $85.11 | Professional | 56 · Pre-op care only | $17.38 | $47.86 | $85.11 |
Where Missouri sits
The same service costs 5.2 times more in Wisconsin than in Hawaii. 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· 25th of 51
$617
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.