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 $77.62 Median $95.50 Typical High $141.25 | Facility | None | $77.62 | $95.50 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $95.50 Typical High $141.25 | Professional | None | $77.62 | $95.50 | $141.25 |
Ambetter Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $194.98 | Professional | None | $112.20 | $147.91 | $194.98 |
BCBS Kansas City Setting Professional Modifier None Typical Low $95.50 Median $104.71 Typical High $147.91 | Professional | None | $95.50 | $104.71 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $478.63 Median $1,698.24 Typical High $2,511.89 | Facility | None | $478.63 | $1,698.24 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $234.42 | Professional | None | $102.33 | $144.54 | $234.42 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,698.24 Typical High $9,549.93 | Facility | None | $54.95 | $1,698.24 | $9,549.93 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $190.55 Typical High $1,513.56 | Professional | None | $100.00 | $190.55 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $190.55 | Professional | None | $95.50 | $123.03 | $190.55 |
4 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 $38.90 Median $46.77 Typical High $47.86 | Professional | 52 · Reduced service | $38.90 | $46.77 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $19.05 Typical High $19.50 | Professional | 53 · Discontinued | $15.85 | $19.05 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $14.13 Typical High $14.45 | Professional | 55 · Aftercare only | $11.75 | $14.13 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $9.33 Typical High $9.55 | Professional | 56 · Pre-op care only | $7.76 | $9.33 | $9.55 |
Where Missouri sits
The same service costs 7.9 times more in Kansas than in New York. 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· 23rd of 51
$166
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.