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 $123.03 Median $4,677.35 Typical High $7,762.47 | Facility | None | $123.03 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $147.91 | Professional | None | $85.11 | $123.03 | $147.91 |
Ambetter Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
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 $93.33 Median $123.03 Typical High $223.87 | Professional | None | $93.33 | $123.03 | $223.87 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $141.25 Median $186.21 Typical High $331.13 | Professional | 50 · Both sides | $141.25 | $186.21 | $331.13 |
BCBS Kansas City Setting Professional Modifier None Typical Low $79.43 Median $125.89 Typical High $169.82 | Professional | None | $79.43 | $125.89 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $79.43 Typical High $109.65 | Facility | None | $58.88 | $79.43 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $251.19 | Professional | None | $87.10 | $128.82 | $251.19 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $549.54 Typical High $1,949.84 | Facility | None | $54.95 | $549.54 | $1,949.84 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $630.96 Typical High $891.25 | Professional | None | $134.90 | $630.96 | $891.25 |
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 $97.72 Median $144.54 Typical High $323.59 | Professional | None | $97.72 | $144.54 | $323.59 |
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 $42.66 Median $61.66 Typical High $74.13 | Professional | 52 · Reduced service | $42.66 | $61.66 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $24.55 Typical High $29.51 | Professional | 53 · Discontinued | $16.98 | $24.55 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $64.57 Median $91.20 Typical High $112.20 | Professional | 54 · Surgery only | $64.57 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $18.20 Typical High $22.39 | Professional | 55 · Aftercare only | $12.88 | $18.20 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $12.30 Typical High $14.79 | Professional | 56 · Pre-op care only | $8.51 | $12.30 | $14.79 |
Where Missouri sits
The same service costs 3.2 times more in Wisconsin than in Texas. 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· 30th of 51
$141
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.