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 $29.51 Median $2,951.21 Typical High $6,309.57 | Facility | None | $29.51 | $2,951.21 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $33.11 Typical High $54.95 | Professional | None | $22.39 | $33.11 | $54.95 |
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 $34.67 Median $46.77 Typical High $66.07 | Professional | None | $34.67 | $46.77 | $66.07 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $20.89 Median $29.51 Typical High $39.81 | Professional | 62 · Two surgeons | $20.89 | $29.51 | $39.81 |
BCBS Kansas City Setting Professional Modifier None Typical Low $26.30 Median $39.81 Typical High $52.48 | Professional | None | $26.30 | $39.81 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $2,137.96 Typical High $2,691.53 | Facility | None | $389.05 | $2,137.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $41.69 Typical High $77.62 | Professional | None | $28.84 | $41.69 | $77.62 |
Medica Setting Facility Modifier None Typical Low $52.48 Median $165.96 Typical High $1,230.27 | Facility | None | $52.48 | $165.96 | $1,230.27 |
Medica Setting Professional Modifier None Typical Low $41.69 Median $457.09 Typical High $501.19 | Professional | None | $41.69 | $457.09 | $501.19 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $2,137.96 | Facility | None | $123.03 | $549.54 | $2,137.96 |
United Setting Professional Modifier None Typical Low $32.36 Median $43.65 Typical High $77.62 | Professional | None | $32.36 | $43.65 | $77.62 |
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 $11.22 Median $14.79 Typical High $18.20 | Professional | 52 · Reduced service | $11.22 | $14.79 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $5.89 Typical High $7.41 | Professional | 53 · Discontinued | $4.47 | $5.89 | $7.41 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $16.98 Median $22.39 Typical High $27.54 | Professional | 54 · Surgery only | $16.98 | $22.39 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $4.47 Typical High $5.50 | Professional | 55 · Aftercare only | $3.39 | $4.47 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $2.95 Typical High $3.72 | Professional | 56 · Pre-op care only | $2.24 | $2.95 | $3.72 |
Where Missouri sits
The same service costs 3.3 times more in Alaska 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· 19th of 51
$52.48
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.