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 $199.53 Median $3,162.28 Typical High $6,309.57 | Facility | None | $199.53 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $177.83 Typical High $245.47 | Professional | None | $72.44 | $177.83 | $245.47 |
Ambetter Setting Professional Modifier None Typical Low $72.44 Median $85.11 Typical High $95.50 | Professional | None | $72.44 | $85.11 | $95.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,819.70 Typical High $3,981.07 | Facility | None | $724.44 | $1,819.70 | $3,981.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $173.78 Typical High $263.03 | Professional | None | $74.13 | $173.78 | $263.03 |
BCBS Kansas City Setting Professional Modifier None Typical Low $66.07 Median $165.96 Typical High $218.78 | Professional | None | $66.07 | $165.96 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $158.49 Typical High $323.59 | Professional | None | $67.61 | $158.49 | $323.59 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $316.23 Typical High $1,230.27 | Facility | None | $54.95 | $316.23 | $1,230.27 |
Medica Setting Professional Modifier None Typical Low $281.84 Median $660.69 Typical High $1,258.93 | Professional | None | $281.84 | $660.69 | $1,258.93 |
Qualchoice Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
United Setting Facility Modifier None Typical Low $245.47 Median $870.96 Typical High $3,548.13 | Facility | None | $245.47 | $870.96 | $3,548.13 |
United Setting Professional Modifier None Typical Low $95.50 Median $194.98 Typical High $380.19 | Professional | None | $95.50 | $194.98 | $380.19 |
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 $36.31 Median $81.28 Typical High $107.15 | Professional | 52 · Reduced service | $36.31 | $81.28 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $25.12 Typical High $42.66 | Professional | 53 · Discontinued | $14.45 | $25.12 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $123.03 Typical High $162.18 | Professional | 54 · Surgery only | $54.95 | $123.03 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $19.05 Typical High $32.36 | Professional | 55 · Aftercare only | $10.96 | $19.05 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $16.22 Typical High $21.38 | Professional | 56 · Pre-op care only | $7.24 | $16.22 | $21.38 |
Where Missouri sits
The same service costs 2.7 times more in Wisconsin than in Utah. 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· 16th of 51
$195
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.