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 $851.14 Median $3,162.28 Typical High $7,762.47 | Facility | None | $851.14 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $616.60 Typical High $1,174.90 | Professional | None | $478.63 | $616.60 | $1,174.90 |
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 $562.34 Median $776.25 Typical High $1,047.13 | Professional | None | $562.34 | $776.25 | $1,047.13 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $831.76 Median $1,174.90 Typical High $1,548.82 | Professional | 50 · Both sides | $831.76 | $1,174.90 | $1,548.82 |
BCBS Kansas City Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $724.44 | Professional | None | $478.63 | $524.81 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $416.87 Typical High $1,659.59 | Facility | None | $309.03 | $416.87 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $1,202.26 | Professional | None | $524.81 | $602.56 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $977.24 Typical High $4,897.79 | Facility | None | $54.95 | $977.24 | $4,897.79 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $1,202.26 Typical High $3,890.45 | Professional | None | $645.65 | $1,202.26 | $3,890.45 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $2,238.72 | Facility | None | $398.11 | $1,148.15 | $2,238.72 |
United Setting Professional Modifier None Typical Low $562.34 Median $831.76 Typical High $1,380.38 | Professional | None | $562.34 | $831.76 | $1,380.38 |
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 $239.88 Median $302.00 Typical High $309.03 | Professional | 52 · Reduced service | $239.88 | $302.00 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $120.23 Typical High $123.03 | Professional | 53 · Discontinued | $95.50 | $120.23 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $457.09 Typical High $467.74 | Professional | 54 · Surgery only | $363.08 | $457.09 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $91.20 Typical High $93.33 | Professional | 55 · Aftercare only | $72.44 | $91.20 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $60.26 Typical High $61.66 | Professional | 56 · Pre-op care only | $47.86 | $60.26 | $61.66 |
Where Missouri sits
The same service costs 4.0 times more in Alaska than in Utah. 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· 14th of 51
$851
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.