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 $102.33 Median $3,162.28 Typical High $6,309.57 | Facility | None | $102.33 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $91.20 Typical High $125.89 | Professional | None | $27.54 | $91.20 | $125.89 |
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 $33.88 Median $56.23 Typical High $154.88 | Professional | None | $33.88 | $56.23 | $154.88 |
BCBS Kansas City Setting Professional Modifier None Typical Low $29.51 Median $97.72 Typical High $144.54 | Professional | None | $29.51 | $97.72 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $93.33 Typical High $131.83 | Facility | None | $58.88 | $93.33 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $87.10 Typical High $223.87 | Professional | None | $28.84 | $87.10 | $223.87 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $208.93 Typical High $1,778.28 | Facility | None | $54.95 | $208.93 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $123.03 Median $741.31 Typical High $812.83 | Professional | None | $123.03 | $741.31 | $812.83 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,137.96 | Facility | None | $123.03 | $602.56 | $2,137.96 |
United Setting Professional Modifier None Typical Low $38.02 Median $95.50 Typical High $223.87 | Professional | None | $38.02 | $95.50 | $223.87 |
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 $13.18 Median $35.48 Typical High $52.48 | Professional | 52 · Reduced service | $13.18 | $35.48 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.25 Median $14.13 Typical High $20.89 | Professional | 53 · Discontinued | $5.25 | $14.13 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.95 Median $52.48 Typical High $79.43 | Professional | 54 · Surgery only | $19.95 | $52.48 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $10.47 Typical High $15.85 | Professional | 55 · Aftercare only | $3.98 | $10.47 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.63 Median $7.08 Typical High $10.47 | Professional | 56 · Pre-op care only | $2.63 | $7.08 | $10.47 |
Where Missouri sits
The same service costs 5.4 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· 24th of 51
$105
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.