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 $275.42 Median $2,511.89 Typical High $6,309.57 | Facility | None | $275.42 | $2,511.89 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $186.21 Typical High $229.09 | Professional | None | $83.18 | $186.21 | $229.09 |
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 $100.00 Median $181.97 Typical High $263.03 | Professional | None | $100.00 | $181.97 | $263.03 |
BCBS Kansas City Setting Professional Modifier None Typical Low $89.13 Median $223.87 Typical High $309.03 | Professional | None | $89.13 | $223.87 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $912.01 Typical High $2,630.27 | Facility | None | $524.81 | $912.01 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $190.55 Typical High $302.00 | Professional | None | $87.10 | $190.55 | $302.00 |
Medica Setting Facility Modifier None Typical Low $239.88 Median $1,445.44 Typical High $12,022.64 | Facility | None | $239.88 | $1,445.44 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $245.47 Median $812.83 Typical High $1,548.82 | Professional | None | $245.47 | $812.83 | $1,548.82 |
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 $104.71 Median $190.55 Typical High $354.81 | Professional | None | $104.71 | $190.55 | $354.81 |
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 $41.69 Median $77.62 Typical High $112.20 | Professional | 52 · Reduced service | $41.69 | $77.62 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $30.90 Typical High $45.71 | Professional | 53 · Discontinued | $16.60 | $30.90 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $114.82 Typical High $169.82 | Professional | 54 · Surgery only | $61.66 | $114.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $22.91 Typical High $33.88 | Professional | 55 · Aftercare only | $12.30 | $22.91 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $15.49 Typical High $22.91 | Professional | 56 · Pre-op care only | $8.32 | $15.49 | $22.91 |
Where Missouri sits
The same service costs 4.2 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· 30th of 51
$191
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.