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 $186.21 Median $3,162.28 Typical High $7,762.47 | Facility | None | $186.21 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $147.91 Typical High $190.55 | Professional | None | $66.07 | $147.91 | $190.55 |
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 $81.28 Median $112.20 Typical High $223.87 | Professional | None | $81.28 | $112.20 | $223.87 |
BCBS Kansas City Setting Professional Modifier None Typical Low $66.07 Median $125.89 Typical High $223.87 | Professional | None | $66.07 | $125.89 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $169.82 Typical High $1,659.59 | Facility | None | $117.49 | $169.82 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $151.36 Typical High $275.42 | Professional | None | $74.13 | $151.36 | $275.42 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $446.68 Typical High $11,481.54 | Facility | None | $123.03 | $446.68 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $776.25 Typical High $1,202.26 | Professional | None | $151.36 | $776.25 | $1,202.26 |
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 $87.10 Median $151.36 Typical High $302.00 | Professional | None | $87.10 | $151.36 | $302.00 |
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 $33.11 Median $66.07 Typical High $93.33 | Professional | 52 · Reduced service | $33.11 | $66.07 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $26.30 Typical High $37.15 | Professional | 53 · Discontinued | $13.18 | $26.30 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $100.00 Typical High $141.25 | Professional | 54 · Surgery only | $48.98 | $100.00 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $19.95 Typical High $28.18 | Professional | 55 · Aftercare only | $9.77 | $19.95 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $13.18 Typical High $18.62 | Professional | 56 · Pre-op care only | $6.61 | $13.18 | $18.62 |
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· 34th of 51
$145
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.