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 $331.13 Median $426.58 Typical High $707.95 | Facility | None | $331.13 | $426.58 | $707.95 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $426.58 Typical High $691.83 | Professional | None | $331.13 | $426.58 | $691.83 |
Ambetter Setting Professional Modifier None Typical Low $489.78 Median $870.96 Typical High $870.96 | Professional | None | $489.78 | $870.96 | $870.96 |
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 $316.23 Median $457.09 Typical High $758.58 | Professional | None | $316.23 | $457.09 | $758.58 |
BCBS Kansas City Setting Professional Modifier None Typical Low $407.38 Median $575.44 Typical High $776.25 | Professional | None | $407.38 | $575.44 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $2,691.53 Typical High $2,691.53 | Facility | None | $1,096.48 | $2,691.53 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $977.24 | Professional | None | $407.38 | $549.54 | $977.24 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,071.52 Typical High $6,606.93 | Facility | None | $54.95 | $1,071.52 | $6,606.93 |
Medica Setting Professional Modifier None Typical Low $446.68 Median $3,090.30 Typical High $4,073.80 | Professional | None | $446.68 | $3,090.30 | $4,073.80 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,290.87 Typical High $10,964.78 | Facility | None | $467.74 | $2,290.87 | $10,964.78 |
United Setting Professional Modifier None Typical Low $338.84 Median $489.78 Typical High $831.76 | Professional | None | $338.84 | $489.78 | $831.76 |
3 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 $165.96 Median $213.80 Typical High $263.03 | Professional | 52 · Reduced service | $165.96 | $213.80 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $64.57 Typical High $79.43 | Professional | 55 · Aftercare only | $50.12 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $42.66 Typical High $52.48 | Professional | 56 · Pre-op care only | $33.11 | $42.66 | $52.48 |
Where Missouri sits
The same service costs 3.1 times more in Alaska than in Indiana. 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
$525
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.