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 $52.48 Median $2,754.23 Typical High $6,309.57 | Facility | None | $52.48 | $2,754.23 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $69.18 Typical High $120.23 | Professional | None | $28.18 | $69.18 | $120.23 |
Ambetter Setting Professional Modifier None Typical Low $87.10 Median $117.49 Typical High $117.49 | Professional | None | $87.10 | $117.49 | $117.49 |
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 $35.48 Median $64.57 Typical High $128.82 | Professional | None | $35.48 | $64.57 | $128.82 |
BCBS Kansas City Setting Professional Modifier None Typical Low $27.54 Median $75.86 Typical High $104.71 | Professional | None | $27.54 | $75.86 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $66.07 Typical High $83.18 | Facility | None | $51.29 | $66.07 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $75.86 Typical High $165.96 | Professional | None | $30.90 | $75.86 | $165.96 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $194.98 Typical High $1,318.26 | Facility | None | $54.95 | $194.98 | $1,318.26 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $288.40 Typical High $660.69 | Professional | None | $100.00 | $288.40 | $660.69 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,137.96 | Facility | None | $123.03 | $602.56 | $2,137.96 |
United Setting Professional Modifier None Typical Low $40.74 Median $79.43 Typical High $162.18 | Professional | None | $40.74 | $79.43 | $162.18 |
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 $13.80 Median $33.88 Typical High $43.65 | Professional | 52 · Reduced service | $13.80 | $33.88 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $13.49 Typical High $17.38 | Professional | 53 · Discontinued | $5.50 | $13.49 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $20.89 Median $50.12 Typical High $66.07 | Professional | 54 · Surgery only | $20.89 | $50.12 | $66.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $10.00 Typical High $13.18 | Professional | 55 · Aftercare only | $4.17 | $10.00 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $6.76 Typical High $8.71 | Professional | 56 · Pre-op care only | $2.75 | $6.76 | $8.71 |
Where Missouri sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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· 27th of 51
$85.11
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.