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 $263.03 Median $2,511.89 Typical High $6,309.57 | Facility | None | $263.03 | $2,511.89 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $181.97 Typical High $218.78 | Professional | None | $77.62 | $181.97 | $218.78 |
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 $85.11 Median $154.88 Typical High $257.04 | Professional | None | $85.11 | $154.88 | $257.04 |
BCBS Kansas City Setting Professional Modifier None Typical Low $85.11 Median $213.80 Typical High $302.00 | Professional | None | $85.11 | $213.80 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $1,659.59 Typical High $2,630.27 | Facility | None | $524.81 | $1,659.59 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $181.97 Typical High $295.12 | Professional | None | $83.18 | $181.97 | $295.12 |
Medica Setting Facility Modifier None Typical Low $218.78 Median $1,445.44 Typical High $12,022.64 | Facility | None | $218.78 | $1,445.44 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $794.33 Typical High $1,479.11 | Professional | None | $218.78 | $794.33 | $1,479.11 |
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 $91.20 Median $177.83 Typical High $346.74 | Professional | None | $91.20 | $177.83 | $346.74 |
6 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 $38.90 Median $72.44 Typical High $109.65 | Professional | 52 · Reduced service | $38.90 | $72.44 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $28.84 Typical High $43.65 | Professional | 53 · Discontinued | $15.49 | $28.84 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $107.15 Typical High $165.96 | Professional | 54 · Surgery only | $58.88 | $107.15 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $21.38 Typical High $33.11 | Professional | 55 · Aftercare only | $11.75 | $21.38 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $14.45 Typical High $21.88 | Professional | 56 · Pre-op care only | $7.76 | $14.45 | $21.88 |
Ambetter Setting Professional Modifier 33 · Preventive service Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 33 · Preventive service | $83.18 | $83.18 | $83.18 |
Where Missouri sits
The same service costs 4.5 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
$186
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.