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 $204.17 Median $3,162.28 Typical High $6,309.57 | Facility | None | $204.17 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $154.88 Typical High $239.88 | Professional | None | $74.13 | $154.88 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $89.13 Median $154.88 Typical High $245.47 | Professional | None | $89.13 | $154.88 | $245.47 |
BCBS Kansas City Setting Professional Modifier None Typical Low $77.62 Median $223.87 Typical High $323.59 | Professional | None | $77.62 | $223.87 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $660.69 Typical High $1,659.59 | Facility | None | $446.68 | $660.69 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $181.97 Typical High $316.23 | Professional | None | $79.43 | $181.97 | $316.23 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $1,445.44 Typical High $12,022.64 | Facility | None | $223.87 | $1,445.44 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $234.42 Median $851.14 Typical High $1,659.59 | Professional | None | $234.42 | $851.14 | $1,659.59 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,235.94 | Facility | None | $562.34 | $1,513.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $91.20 Median $186.21 Typical High $380.19 | Professional | None | $91.20 | $186.21 | $380.19 |
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 $37.15 Median $77.62 Typical High $120.23 | Professional | 52 · Reduced service | $37.15 | $77.62 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $30.90 Typical High $47.86 | Professional | 53 · Discontinued | $14.79 | $30.90 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $114.82 Typical High $177.83 | Professional | 54 · Surgery only | $54.95 | $114.82 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $22.91 Typical High $35.48 | Professional | 55 · Aftercare only | $10.96 | $22.91 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $15.49 Typical High $23.99 | Professional | 56 · Pre-op care only | $7.41 | $15.49 | $23.99 |
Where Missouri sits
The same service costs 4.1 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
$195
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.