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 $109.65 Median $3,162.28 Typical High $6,309.57 | Facility | None | $109.65 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $89.13 Typical High $134.90 | Professional | None | $38.02 | $89.13 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $165.96 Median $190.55 Typical High $190.55 | Professional | None | $165.96 | $190.55 | $190.55 |
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 $44.67 Median $61.66 Typical High $117.49 | Professional | None | $44.67 | $61.66 | $117.49 |
BCBS Kansas City Setting Professional Modifier None Typical Low $41.69 Median $112.20 Typical High $169.82 | Professional | None | $41.69 | $112.20 | $169.82 |
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 $40.74 Median $93.33 Typical High $165.96 | Professional | None | $40.74 | $93.33 | $165.96 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $239.88 Typical High $1,288.25 | Facility | None | $54.95 | $239.88 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $117.49 Median $446.68 Typical High $870.96 | Professional | None | $117.49 | $446.68 | $870.96 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $2,137.96 | Facility | None | $123.03 | $537.03 | $2,137.96 |
United Setting Professional Modifier None Typical Low $44.67 Median $95.50 Typical High $194.98 | Professional | None | $44.67 | $95.50 | $194.98 |
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 $19.05 Median $38.02 Typical High $63.10 | Professional | 52 · Reduced service | $19.05 | $38.02 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $15.14 Typical High $25.70 | Professional | 53 · Discontinued | $7.59 | $15.14 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $56.23 Typical High $95.50 | Professional | 54 · Surgery only | $28.18 | $56.23 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $11.22 Typical High $19.05 | Professional | 55 · Aftercare only | $5.75 | $11.22 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $7.59 Typical High $12.88 | Professional | 56 · Pre-op care only | $3.80 | $7.59 | $12.88 |
Where Missouri sits
The same service costs 3.4 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· 28th of 51
$95.50
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.