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 $138.04 Median $3,162.28 Typical High $7,762.47 | Facility | None | $138.04 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $109.65 Typical High $138.04 | Professional | None | $63.10 | $109.65 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,819.70 Typical High $3,981.07 | Facility | None | $724.44 | $1,819.70 | $3,981.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $97.72 Typical High $162.18 | Professional | None | $75.86 | $97.72 | $162.18 |
BCBS Kansas City Setting Professional Modifier None Typical Low $64.57 Median $112.20 Typical High $151.36 | Professional | None | $64.57 | $112.20 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $114.82 Typical High $199.53 | Professional | None | $72.44 | $114.82 | $199.53 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $263.03 Typical High $1,258.93 | Facility | None | $54.95 | $263.03 | $1,258.93 |
Medica Setting Professional Modifier None Typical Low $131.83 Median $1,071.52 Typical High $3,548.13 | Professional | None | $131.83 | $1,071.52 | $3,548.13 |
United Setting Facility Modifier None Typical Low $245.47 Median $870.96 Typical High $3,548.13 | Facility | None | $245.47 | $870.96 | $3,548.13 |
United Setting Professional Modifier None Typical Low $83.18 Median $131.83 Typical High $234.42 | Professional | None | $83.18 | $131.83 | $234.42 |
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 $31.62 Median $46.77 Typical High $69.18 | Professional | 52 · Reduced service | $31.62 | $46.77 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $18.62 Typical High $27.54 | Professional | 53 · Discontinued | $12.88 | $18.62 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $69.18 Typical High $102.33 | Professional | 54 · Surgery only | $47.86 | $69.18 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $13.80 Typical High $20.42 | Professional | 55 · Aftercare only | $9.55 | $13.80 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $9.33 Typical High $13.80 | Professional | 56 · Pre-op care only | $6.31 | $9.33 | $13.80 |
Where Missouri sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 30th of 51
$120
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.