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 $281.84 Median $2,511.89 Typical High $6,309.57 | Facility | None | $281.84 | $2,511.89 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $204.17 Typical High $239.88 | Professional | None | $100.00 | $204.17 | $239.88 |
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 $114.82 Median $199.53 Typical High $288.40 | Professional | None | $114.82 | $199.53 | $288.40 |
BCBS Kansas City Setting Professional Modifier None Typical Low $107.15 Median $234.42 Typical High $323.59 | Professional | None | $107.15 | $234.42 | $323.59 |
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 $107.15 Median $199.53 Typical High $323.59 | Professional | None | $107.15 | $199.53 | $323.59 |
Medica Setting Facility Modifier None Typical Low $257.04 Median $1,445.44 Typical High $12,022.64 | Facility | None | $257.04 | $1,445.44 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $251.19 Median $851.14 Typical High $1,621.81 | Professional | None | $251.19 | $851.14 | $1,621.81 |
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 $123.03 Median $213.80 Typical High $389.05 | Professional | None | $123.03 | $213.80 | $389.05 |
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 $50.12 Median $91.20 Typical High $117.49 | Professional | 52 · Reduced service | $50.12 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $36.31 Typical High $47.86 | Professional | 53 · Discontinued | $20.42 | $36.31 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $138.04 Typical High $177.83 | Professional | 54 · Surgery only | $75.86 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $27.54 Typical High $35.48 | Professional | 55 · Aftercare only | $15.14 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $18.20 Typical High $23.99 | Professional | 56 · Pre-op care only | $10.00 | $18.20 | $23.99 |
Where Missouri sits
The same service costs 3.8 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· 25th of 51
$219
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.