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 $61.66 Median $2,511.89 Typical High $6,309.57 | Facility | None | $61.66 | $2,511.89 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $89.13 Typical High $141.25 | Professional | None | $46.77 | $89.13 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $131.83 | Professional | None | $70.79 | $70.79 | $131.83 |
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 $60.26 Median $93.33 Typical High $173.78 | Professional | None | $60.26 | $93.33 | $173.78 |
BCBS Kansas City Setting Professional Modifier None Typical Low $48.98 Median $97.72 Typical High $134.90 | Professional | None | $48.98 | $97.72 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $100.00 Typical High $1,659.59 | Facility | None | $67.61 | $100.00 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $100.00 Typical High $190.55 | Professional | None | $53.70 | $100.00 | $190.55 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $239.88 Typical High $1,288.25 | Facility | None | $54.95 | $239.88 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $120.23 Median $588.84 Typical High $724.44 | Professional | None | $120.23 | $588.84 | $724.44 |
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 $69.18 Median $112.20 Typical High $204.17 | Professional | None | $69.18 | $112.20 | $204.17 |
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 $23.44 Median $44.67 Typical High $56.23 | Professional | 52 · Reduced service | $23.44 | $44.67 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $17.78 Typical High $22.39 | Professional | 53 · Discontinued | $9.33 | $17.78 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $66.07 Typical High $85.11 | Professional | 54 · Surgery only | $35.48 | $66.07 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $13.49 Typical High $16.98 | Professional | 55 · Aftercare only | $7.08 | $13.49 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $8.91 Typical High $11.22 | Professional | 56 · Pre-op care only | $4.68 | $8.91 | $11.22 |
Where Missouri sits
The same service costs 2.8 times more in Wisconsin than in Kentucky. 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
$110
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.