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 $79.43 Median $3,162.28 Typical High $6,309.57 | Facility | None | $79.43 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $79.43 Typical High $131.83 | Professional | None | $57.54 | $79.43 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $97.72 | Professional | None | $89.13 | $89.13 | $97.72 |
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 $75.86 Median $97.72 Typical High $162.18 | Professional | None | $75.86 | $97.72 | $162.18 |
BCBS Kansas City Setting Professional Modifier None Typical Low $61.66 Median $102.33 Typical High $141.25 | Professional | None | $61.66 | $102.33 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $87.10 Typical High $1,659.59 | Facility | None | $58.88 | $87.10 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $102.33 Typical High $190.55 | Professional | None | $64.57 | $102.33 | $190.55 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $537.03 Typical High $1,949.84 | Facility | None | $54.95 | $537.03 | $1,949.84 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $758.58 Typical High $776.25 | Professional | None | $100.00 | $758.58 | $776.25 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $2,398.83 | Facility | None | $398.11 | $1,148.15 | $2,398.83 |
United Setting Professional Modifier None Typical Low $72.44 Median $104.71 Typical High $186.21 | Professional | None | $72.44 | $104.71 | $186.21 |
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 $25.12 Median $39.81 Typical High $50.12 | Professional | 52 · Reduced service | $25.12 | $39.81 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $15.85 Typical High $19.95 | Professional | 53 · Discontinued | $10.00 | $15.85 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $58.88 Typical High $75.86 | Professional | 54 · Surgery only | $37.15 | $58.88 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $12.02 Typical High $15.14 | Professional | 55 · Aftercare only | $7.41 | $12.02 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $7.94 Typical High $10.00 | Professional | 56 · Pre-op care only | $5.01 | $7.94 | $10.00 |
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· 33rd of 51
$107
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.