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 $67.61 Median $4,677.35 Typical High $7,762.47 | Facility | None | $67.61 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $67.61 Typical High $87.10 | Professional | None | $37.15 | $67.61 | $87.10 |
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 $45.71 Median $66.07 Typical High $117.49 | Professional | None | $45.71 | $66.07 | $117.49 |
BCBS Kansas City Setting Professional Modifier None Typical Low $38.02 Median $74.13 Typical High $104.71 | Professional | None | $38.02 | $74.13 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $66.07 | Facility | None | $50.12 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $77.62 Typical High $151.36 | Professional | None | $41.69 | $77.62 | $151.36 |
Medica Setting Facility Modifier None Typical Low $100.00 Median $407.38 Typical High $11,481.54 | Facility | None | $100.00 | $407.38 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $91.20 Median $645.65 Typical High $977.24 | Professional | None | $91.20 | $645.65 | $977.24 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $2,137.96 | Facility | None | $123.03 | $537.03 | $2,137.96 |
United Setting Professional Modifier None Typical Low $48.98 Median $85.11 Typical High $151.36 | Professional | None | $48.98 | $85.11 | $151.36 |
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 $18.62 Median $33.88 Typical High $42.66 | Professional | 52 · Reduced service | $18.62 | $33.88 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $13.49 Typical High $17.38 | Professional | 53 · Discontinued | $7.41 | $13.49 | $17.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $51.29 Typical High $64.57 | Professional | 54 · Surgery only | $28.18 | $51.29 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $10.23 Typical High $12.88 | Professional | 55 · Aftercare only | $5.62 | $10.23 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $6.76 Typical High $8.71 | Professional | 56 · Pre-op care only | $3.72 | $6.76 | $8.71 |
Where Missouri sits
The same service costs 3.4 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· 29th of 51
$81.28
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.