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 $354.81 Median $3,715.35 Typical High $6,309.57 | Facility | None | $354.81 | $3,715.35 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $354.81 Typical High $446.68 | Professional | None | $151.36 | $354.81 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $537.03 Median $1,348.96 Typical High $2,630.27 | Facility | None | $537.03 | $1,348.96 | $2,630.27 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $309.03 Typical High $645.65 | Professional | None | $190.55 | $309.03 | $645.65 |
BCBS Kansas City Setting Professional Modifier None Typical Low $154.88 Median $354.81 Typical High $489.78 | Professional | None | $154.88 | $354.81 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $446.68 Typical High $2,187.76 | Facility | None | $309.03 | $446.68 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $371.54 Typical High $776.25 | Professional | None | $169.82 | $371.54 | $776.25 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $1,096.48 Typical High $16,218.10 | Facility | None | $380.19 | $1,096.48 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $501.19 Median $1,445.44 Typical High $2,818.38 | Professional | None | $501.19 | $1,445.44 | $2,818.38 |
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 $199.53 Median $426.58 Typical High $812.83 | Professional | None | $199.53 | $426.58 | $812.83 |
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 $74.13 Median $169.82 Typical High $218.78 | Professional | 52 · Reduced service | $74.13 | $169.82 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $67.61 Typical High $87.10 | Professional | 53 · Discontinued | $30.20 | $67.61 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $251.19 Typical High $331.13 | Professional | 54 · Surgery only | $112.20 | $251.19 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $51.29 Typical High $66.07 | Professional | 55 · Aftercare only | $22.39 | $51.29 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $33.88 Typical High $43.65 | Professional | 56 · Pre-op care only | $15.14 | $33.88 | $43.65 |
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· 22nd of 51
$417
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.