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 $45.71 Median $4,570.88 Typical High $7,762.47 | Facility | None | $45.71 | $4,570.88 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $57.54 Typical High $93.33 | Professional | None | $35.48 | $57.54 | $93.33 |
Ambetter Setting Professional Modifier None Typical Low $66.07 Median $104.71 Typical High $104.71 | Professional | None | $66.07 | $104.71 | $104.71 |
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 $52.48 Median $69.18 Typical High $117.49 | Professional | None | $52.48 | $69.18 | $117.49 |
BCBS Kansas City Setting Professional Modifier None Typical Low $42.66 Median $70.79 Typical High $97.72 | Professional | None | $42.66 | $70.79 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $50.12 Typical High $66.07 | Facility | None | $36.31 | $50.12 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $72.44 Typical High $128.82 | Professional | None | $44.67 | $72.44 | $128.82 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $208.93 Typical High $1,288.25 | Facility | None | $54.95 | $208.93 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $81.28 Median $338.84 Typical High $549.54 | Professional | None | $81.28 | $338.84 | $549.54 |
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 $51.29 Median $79.43 Typical High $131.83 | Professional | None | $51.29 | $79.43 | $131.83 |
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 $17.78 Median $28.84 Typical High $36.31 | Professional | 52 · Reduced service | $17.78 | $28.84 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $11.48 Typical High $14.45 | Professional | 53 · Discontinued | $7.08 | $11.48 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.30 Median $42.66 Typical High $53.70 | Professional | 54 · Surgery only | $26.30 | $42.66 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $8.51 Typical High $10.72 | Professional | 55 · Aftercare only | $5.25 | $8.51 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $5.75 Typical High $7.24 | Professional | 56 · Pre-op care only | $3.55 | $5.75 | $7.24 |
Where Missouri sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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· 36th of 51
$77.62
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.