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 $3,162.28 Typical High $6,309.57 | Facility | None | $331.13 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $288.40 Typical High $380.19 | Professional | None | $131.83 | $288.40 | $380.19 |
Ambetter Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Professional | None | $199.53 | $199.53 | $199.53 |
Anthem BCBS Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $323.59 | Professional | None | $177.83 | $245.47 | $323.59 |
BCBS Kansas City Setting Professional Modifier None Typical Low $147.91 Median $354.81 Typical High $478.63 | Professional | None | $147.91 | $354.81 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $338.84 Typical High $588.84 | Professional | None | $169.82 | $338.84 | $588.84 |
Medica Setting Facility Modifier None Typical Low $245.47 Median $870.96 Typical High $1,513.56 | Facility | None | $245.47 | $870.96 | $1,513.56 |
Medica Setting Professional Modifier None Typical Low $467.74 Median $1,288.25 Typical High $2,570.40 | Professional | None | $467.74 | $1,288.25 | $2,570.40 |
United Setting Facility Modifier None Typical Low $245.47 Median $870.96 Typical High $3,548.13 | Facility | None | $245.47 | $870.96 | $3,548.13 |
United Setting Professional Modifier None Typical Low $199.53 Median $371.54 Typical High $660.69 | Professional | None | $199.53 | $371.54 | $660.69 |
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 $64.57 Median $128.82 Typical High $177.83 | Professional | 52 · Reduced service | $64.57 | $128.82 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $51.29 Typical High $70.79 | Professional | 53 · Discontinued | $26.30 | $51.29 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $190.55 Typical High $269.15 | Professional | 54 · Surgery only | $97.72 | $190.55 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $38.02 Typical High $53.70 | Professional | 55 · Aftercare only | $19.50 | $38.02 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $25.70 Typical High $35.48 | Professional | 56 · Pre-op care only | $13.18 | $25.70 | $35.48 |
Where Missouri sits
The same service costs 3.3 times more in Alaska than in Virginia. 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· 30th of 51
$339
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.