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 $138.04 Median $3,162.28 Typical High $6,309.57 | Facility | None | $138.04 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $251.19 | Professional | None | $107.15 | $134.90 | $251.19 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $204.17 Median $3,467.37 Typical High $7,079.46 | Facility | None | $204.17 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $281.84 | Professional | None | $138.04 | $190.55 | $281.84 |
BCBS Kansas City Setting Professional Modifier None Typical Low $114.82 Median $177.83 Typical High $245.47 | Professional | None | $114.82 | $177.83 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $144.54 Typical High $1,659.59 | Facility | None | $95.50 | $144.54 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $173.78 Typical High $331.13 | Professional | None | $120.23 | $173.78 | $331.13 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $562.34 Typical High $1,949.84 | Facility | None | $54.95 | $562.34 | $1,949.84 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $891.25 Typical High $1,318.26 | Professional | None | $173.78 | $891.25 | $1,318.26 |
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 $134.90 Median $186.21 Typical High $346.74 | Professional | None | $134.90 | $186.21 | $346.74 |
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 $46.77 Median $67.61 Typical High $87.10 | Professional | 52 · Reduced service | $46.77 | $67.61 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $27.54 Typical High $34.67 | Professional | 53 · Discontinued | $18.62 | $27.54 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $102.33 Typical High $128.82 | Professional | 54 · Surgery only | $69.18 | $102.33 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $20.42 Typical High $25.70 | Professional | 55 · Aftercare only | $13.80 | $20.42 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $13.49 Typical High $17.38 | Professional | 56 · Pre-op care only | $9.33 | $13.49 | $17.38 |
Where Missouri sits
The same service costs 3.7 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
$191
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.