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 $154.88 Median $3,162.28 Typical High $7,762.47 | Facility | None | $154.88 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $125.89 Typical High $173.78 | Professional | None | $72.44 | $125.89 | $173.78 |
Ambetter Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
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 $91.20 Median $134.90 Typical High $229.09 | Professional | None | $91.20 | $134.90 | $229.09 |
BCBS Kansas City Setting Professional Modifier None Typical Low $75.86 Median $138.04 Typical High $186.21 | Professional | None | $75.86 | $138.04 | $186.21 |
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 $83.18 Median $141.25 Typical High $288.40 | Professional | None | $83.18 | $141.25 | $288.40 |
Medica Setting Facility Modifier None Typical Low $218.78 Median $1,096.48 Typical High $12,022.64 | Facility | None | $218.78 | $1,096.48 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $275.42 Typical High $1,819.70 | Professional | None | $134.90 | $275.42 | $1,819.70 |
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 $102.33 Median $151.36 Typical High $281.84 | Professional | None | $102.33 | $151.36 | $281.84 |
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 $36.31 Median $63.10 Typical High $77.62 | Professional | 52 · Reduced service | $36.31 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $25.12 Typical High $30.90 | Professional | 53 · Discontinued | $14.45 | $25.12 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $93.33 Typical High $117.49 | Professional | 54 · Surgery only | $54.95 | $93.33 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $18.62 Typical High $23.44 | Professional | 55 · Aftercare only | $10.96 | $18.62 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $12.59 Typical High $15.49 | Professional | 56 · Pre-op care only | $7.24 | $12.59 | $15.49 |
Where Missouri sits
The same service costs 3.6 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· 38th of 51
$151
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.