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 $173.78 Median $2,511.89 Typical High $6,309.57 | Facility | None | $173.78 | $2,511.89 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $112.20 Typical High $144.54 | Professional | None | $44.67 | $112.20 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $131.83 | Professional | None | $61.66 | $61.66 | $131.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $165.96 Median $1,348.96 Typical High $2,630.27 | Facility | None | $165.96 | $1,348.96 | $2,630.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $79.43 Typical High $151.36 | Professional | None | $51.29 | $79.43 | $151.36 |
BCBS Kansas City Setting Professional Modifier None Typical Low $46.77 Median $141.25 Typical High $199.53 | Professional | None | $46.77 | $141.25 | $199.53 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $380.19 Typical High $2,630.27 | Facility | None | $117.49 | $380.19 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $109.65 Typical High $199.53 | Professional | None | $46.77 | $109.65 | $199.53 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $537.03 Typical High $1,949.84 | Facility | None | $134.90 | $537.03 | $1,949.84 |
Medica Setting Professional Modifier None Typical Low $144.54 Median $489.78 Typical High $954.99 | Professional | None | $144.54 | $489.78 | $954.99 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $2,691.53 | Facility | None | $398.11 | $1,148.15 | $2,691.53 |
United Setting Professional Modifier None Typical Low $52.48 Median $114.82 Typical High $229.09 | Professional | None | $52.48 | $114.82 | $229.09 |
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 $21.88 Median $50.12 Typical High $69.18 | Professional | 52 · Reduced service | $21.88 | $50.12 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $19.95 Typical High $27.54 | Professional | 53 · Discontinued | $8.91 | $19.95 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $74.13 Typical High $102.33 | Professional | 54 · Surgery only | $33.11 | $74.13 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $15.14 Typical High $20.42 | Professional | 55 · Aftercare only | $6.61 | $15.14 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $10.00 Typical High $13.80 | Professional | 56 · Pre-op care only | $4.47 | $10.00 | $13.80 |
Where Missouri sits
The same service costs 3.5 times more in Alaska 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· 26th of 51
$117
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.