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 $69.18 Median $2,511.89 Typical High $6,309.57 | Facility | None | $69.18 | $2,511.89 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $87.10 Typical High $144.54 | Professional | None | $54.95 | $87.10 | $144.54 |
Ambetter Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $147.91 | Professional | None | $89.13 | $125.89 | $147.91 |
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 $79.43 Median $102.33 Typical High $169.82 | Professional | None | $79.43 | $102.33 | $169.82 |
BCBS Kansas City Setting Professional Modifier None Typical Low $57.54 Median $97.72 Typical High $138.04 | Professional | None | $57.54 | $97.72 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $77.62 | Facility | None | $50.12 | $66.07 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $100.00 Typical High $218.78 | Professional | None | $61.66 | $100.00 | $218.78 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $288.40 Typical High $1,380.38 | Facility | None | $54.95 | $288.40 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $467.74 Typical High $758.58 | Professional | None | $114.82 | $467.74 | $758.58 |
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 $79.43 Median $117.49 Typical High $186.21 | Professional | None | $79.43 | $117.49 | $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 $23.99 Median $38.90 Typical High $48.98 | Professional | 52 · Reduced service | $23.99 | $38.90 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $15.49 Typical High $19.50 | Professional | 53 · Discontinued | $9.55 | $15.49 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $58.88 Typical High $72.44 | Professional | 54 · Surgery only | $36.31 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $11.75 Typical High $14.45 | Professional | 55 · Aftercare only | $7.24 | $11.75 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $7.76 Typical High $9.77 | Professional | 56 · Pre-op care only | $4.79 | $7.76 | $9.77 |
Where Missouri sits
The same service costs 3.0 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· 29th of 51
$115
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.