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 $50.12 Median $4,570.88 Typical High $7,762.47 | Facility | None | $50.12 | $4,570.88 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $162.18 Typical High $275.42 | Professional | None | $39.81 | $162.18 | $275.42 |
Ambetter Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $70.79 | Professional | None | $50.12 | $50.12 | $70.79 |
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 $48.98 Median $83.18 Typical High $323.59 | Professional | None | $48.98 | $83.18 | $323.59 |
BCBS Kansas City Setting Professional Modifier None Typical Low $39.81 Median $194.98 Typical High $263.03 | Professional | None | $39.81 | $194.98 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $147.91 Typical High $363.08 | Professional | None | $44.67 | $147.91 | $363.08 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $331.13 Typical High $1,230.27 | Facility | None | $54.95 | $331.13 | $1,230.27 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $776.25 Typical High $2,089.30 | Professional | None | $257.04 | $776.25 | $2,089.30 |
Qualchoice Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Professional | None | $66.07 | $66.07 | $66.07 |
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 $52.48 Median $190.55 Typical High $446.68 | Professional | None | $52.48 | $190.55 | $446.68 |
4 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 $19.95 Median $75.86 Typical High $123.03 | Professional | 52 · Reduced service | $19.95 | $75.86 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $30.90 Typical High $48.98 | Professional | 53 · Discontinued | $7.94 | $30.90 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $22.91 Typical High $36.31 | Professional | 55 · Aftercare only | $6.03 | $22.91 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $15.14 Typical High $24.55 | Professional | 56 · Pre-op care only | $3.98 | $15.14 | $24.55 |
Where Missouri sits
The same service costs 5.2 times more in North Carolina than in Hawaii. 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· 15th of 51
$204
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.