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 $81.28 Median $3,162.28 Typical High $7,762.47 | Facility | None | $81.28 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $69.18 Typical High $83.18 | Professional | None | $53.70 | $69.18 | $83.18 |
Ambetter Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | None | $48.98 | $48.98 | $48.98 |
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 $58.88 Median $75.86 Typical High $112.20 | Professional | None | $58.88 | $75.86 | $112.20 |
BCBS Kansas City Setting Professional Modifier None Typical Low $54.95 Median $79.43 Typical High $109.65 | Professional | None | $54.95 | $79.43 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $70.79 Typical High $1,659.59 | Facility | None | $47.86 | $70.79 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $72.44 Typical High $128.82 | Professional | None | $57.54 | $72.44 | $128.82 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $812.83 Typical High $2,630.27 | Facility | None | $54.95 | $812.83 | $2,630.27 |
Medica Setting Professional Modifier None Typical Low $102.33 Median $436.52 Typical High $549.54 | Professional | None | $102.33 | $436.52 | $549.54 |
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 $60.26 Median $95.50 Typical High $151.36 | Professional | None | $60.26 | $95.50 | $151.36 |
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 $26.92 Median $34.67 Typical High $39.81 | Professional | 52 · Reduced service | $26.92 | $34.67 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $13.80 Typical High $16.22 | Professional | 53 · Discontinued | $10.96 | $13.80 | $16.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $51.29 Typical High $60.26 | Professional | 54 · Surgery only | $40.74 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $10.47 Typical High $12.02 | Professional | 55 · Aftercare only | $8.13 | $10.47 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $6.92 Typical High $7.94 | Professional | 56 · Pre-op care only | $5.37 | $6.92 | $7.94 |
Where Missouri sits
The same service costs 4.3 times more in Alaska than in New Jersey. 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· 29th of 51
$83.18
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.