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 $363.08 Median $3,162.28 Typical High $7,762.47 | Facility | None | $363.08 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $295.12 Typical High $380.19 | Professional | None | $79.43 | $295.12 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $257.04 Typical High $380.19 | Professional | None | $83.18 | $257.04 | $380.19 |
BCBS Kansas City Setting Professional Modifier None Typical Low $87.10 Median $346.74 Typical High $489.78 | Professional | None | $87.10 | $346.74 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $204.17 Typical High $1,659.59 | Facility | None | $134.90 | $204.17 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $218.78 Typical High $478.63 | Professional | None | $85.11 | $218.78 | $478.63 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $346.74 Typical High $1,230.27 | Facility | None | $54.95 | $346.74 | $1,230.27 |
Medica Setting Professional Modifier None Typical Low $426.58 Median $1,174.90 Typical High $2,454.71 | Professional | None | $426.58 | $1,174.90 | $2,454.71 |
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 $97.72 Median $275.42 Typical High $616.60 | Professional | None | $97.72 | $275.42 | $616.60 |
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 $39.81 Median $131.83 Typical High $177.83 | Professional | 52 · Reduced service | $39.81 | $131.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $52.48 Typical High $72.44 | Professional | 53 · Discontinued | $15.85 | $52.48 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $194.98 Typical High $269.15 | Professional | 54 · Surgery only | $60.26 | $194.98 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $38.90 Typical High $53.70 | Professional | 55 · Aftercare only | $12.02 | $38.90 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $26.30 Typical High $36.31 | Professional | 56 · Pre-op care only | $7.94 | $26.30 | $36.31 |
Where Missouri sits
The same service costs 4.8 times more in Wisconsin than in Washington, DC. 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· 21st of 51
$316
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.