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 $1,174.90 Median $2,570.40 Typical High $6,309.57 | Facility | None | $1,174.90 | $2,570.40 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $158.49 | Professional | None | $123.03 | $134.90 | $158.49 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $1,348.96 Typical High $2,630.27 | Facility | None | $537.03 | $1,348.96 | $2,630.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $257.04 Typical High $457.09 | Professional | None | $138.04 | $257.04 | $457.09 |
BCBS Kansas City Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $194.98 | Professional | None | $123.03 | $134.90 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,230.27 Typical High $2,630.27 | Facility | None | $524.81 | $1,230.27 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $316.23 | Professional | None | $125.89 | $147.91 | $316.23 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $1,584.89 Typical High $12,022.64 | Facility | None | $446.68 | $1,584.89 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $165.96 Median $1,862.09 Typical High $1,862.09 | Professional | None | $165.96 | $1,862.09 | $1,862.09 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,548.82 Typical High $3,235.94 | Facility | None | $562.34 | $1,548.82 | $3,235.94 |
United Setting Professional Modifier None Typical Low $125.89 Median $302.00 Typical High $338.84 | Professional | None | $125.89 | $302.00 | $338.84 |
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 $61.66 Median $66.07 Typical High $74.13 | Professional | 52 · Reduced service | $61.66 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $26.92 Typical High $30.20 | Professional | 53 · Discontinued | $24.55 | $26.92 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $100.00 Typical High $112.20 | Professional | 54 · Surgery only | $93.33 | $100.00 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $19.95 Typical High $22.39 | Professional | 55 · Aftercare only | $18.62 | $19.95 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $13.18 Typical High $14.79 | Professional | 56 · Pre-op care only | $12.30 | $13.18 | $14.79 |
Where Missouri sits
The same service costs 5.4 times more in Alaska 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· 10th of 51
$282
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.