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 $3,162.28 Typical High $7,762.47 | Facility | None | $173.78 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $131.83 Typical High $173.78 | Professional | None | $37.15 | $131.83 | $173.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $1,621.81 Typical High $3,890.45 | Facility | None | $151.36 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $43.65 Median $69.18 Typical High $190.55 | Professional | None | $43.65 | $69.18 | $190.55 |
BCBS Kansas City Setting Professional Modifier None Typical Low $38.90 Median $158.49 Typical High $223.87 | Professional | None | $38.90 | $158.49 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $66.07 | Facility | None | $50.12 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $125.89 Typical High $239.88 | Professional | None | $39.81 | $125.89 | $239.88 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $549.54 Typical High $1,949.84 | Facility | None | $54.95 | $549.54 | $1,949.84 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $602.56 Typical High $1,202.26 | Professional | None | $181.97 | $602.56 | $1,202.26 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $2,398.83 | Facility | None | $398.11 | $1,148.15 | $2,398.83 |
United Setting Professional Modifier None Typical Low $43.65 Median $120.23 Typical High $288.40 | Professional | None | $43.65 | $120.23 | $288.40 |
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 $18.62 Median $57.54 Typical High $87.10 | Professional | 52 · Reduced service | $18.62 | $57.54 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $23.44 Typical High $34.67 | Professional | 53 · Discontinued | $7.41 | $23.44 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $27.54 Median $87.10 Typical High $131.83 | Professional | 54 · Surgery only | $27.54 | $87.10 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $17.38 Typical High $26.30 | Professional | 55 · Aftercare only | $5.50 | $17.38 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $11.75 Typical High $17.38 | Professional | 56 · Pre-op care only | $3.72 | $11.75 | $17.38 |
Where Missouri sits
The same service costs 4.6 times more in Wisconsin 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· 20th of 51
$145
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.