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 $56.23 Median $2,570.40 Typical High $6,309.57 | Facility | None | $56.23 | $2,570.40 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $81.28 Typical High $112.20 | Professional | None | $39.81 | $81.28 | $112.20 |
Ambetter Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,905.46 Typical High $4,265.80 | Facility | None | $724.44 | $1,905.46 | $4,265.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $48.98 Median $102.33 Typical High $165.96 | Professional | None | $48.98 | $102.33 | $165.96 |
BCBS Kansas City Setting Professional Modifier None Typical Low $39.81 Median $89.13 Typical High $131.83 | Professional | None | $39.81 | $89.13 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $91.20 Typical High $169.82 | Professional | None | $44.67 | $91.20 | $169.82 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $251.19 Typical High $1,288.25 | Facility | None | $54.95 | $251.19 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $102.33 Median $1,778.28 Typical High $1,778.28 | Professional | None | $102.33 | $1,778.28 | $1,778.28 |
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 $109.65 Typical High $173.78 | Professional | None | $52.48 | $109.65 | $173.78 |
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 $19.95 Median $39.81 Typical High $51.29 | Professional | 52 · Reduced service | $19.95 | $39.81 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $16.22 Typical High $20.42 | Professional | 53 · Discontinued | $7.94 | $16.22 | $20.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $60.26 Typical High $77.62 | Professional | 54 · Surgery only | $30.20 | $60.26 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $12.02 Typical High $15.49 | Professional | 55 · Aftercare only | $6.03 | $12.02 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $8.13 Typical High $10.23 | Professional | 56 · Pre-op care only | $3.98 | $8.13 | $10.23 |
Where Missouri sits
The same service costs 2.5 times more in North Carolina 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· 21st of 51
$107
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.