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 $1,148.15 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,148.15 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $229.09 Typical High $269.15 | Professional | None | $208.93 | $229.09 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,230.27 Typical High $2,511.89 | Facility | None | $512.86 | $1,230.27 | $2,511.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $407.38 | Professional | None | $234.42 | $323.59 | $407.38 |
BCBS Kansas City Setting Professional Modifier None Typical Low $204.17 Median $229.09 Typical High $323.59 | Professional | None | $204.17 | $229.09 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $851.14 Typical High $3,311.31 | Facility | None | $588.84 | $851.14 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $223.87 Typical High $380.19 | Professional | None | $213.80 | $223.87 | $380.19 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,174.90 Typical High $3,630.78 | Facility | None | $54.95 | $1,174.90 | $3,630.78 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $537.03 Typical High $1,698.24 | Professional | None | $275.42 | $537.03 | $1,698.24 |
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 $213.80 Median $323.59 Typical High $549.54 | Professional | None | $213.80 | $323.59 | $549.54 |
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 $104.71 Median $112.20 Typical High $125.89 | Professional | 52 · Reduced service | $104.71 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $44.67 Typical High $50.12 | Professional | 53 · Discontinued | $41.69 | $44.67 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $165.96 Typical High $190.55 | Professional | 54 · Surgery only | $154.88 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $33.88 Typical High $38.02 | Professional | 55 · Aftercare only | $31.62 | $33.88 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $22.39 Typical High $25.12 | Professional | 56 · Pre-op care only | $20.89 | $22.39 | $25.12 |
Where Missouri sits
The same service costs 4.7 times more in Wyoming 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· 24th of 51
$324
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.