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 $7,762.47 | Facility | None | $331.13 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $269.15 Typical High $331.13 | Professional | None | $120.23 | $269.15 | $331.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $239.88 Typical High $309.03 | Professional | None | $173.78 | $239.88 | $309.03 |
BCBS Kansas City Setting Professional Modifier None Typical Low $138.04 Median $323.59 Typical High $436.52 | Professional | None | $138.04 | $323.59 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $309.03 Typical High $562.34 | Professional | None | $154.88 | $309.03 | $562.34 |
Medica Setting Facility Modifier None Typical Low $245.47 Median $831.76 Typical High $1,513.56 | Facility | None | $245.47 | $831.76 | $1,513.56 |
Medica Setting Professional Modifier None Typical Low $436.52 Median $1,174.90 Typical High $2,344.23 | Professional | None | $436.52 | $1,174.90 | $2,344.23 |
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 $190.55 Median $346.74 Typical High $630.96 | Professional | None | $190.55 | $346.74 | $630.96 |
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 $60.26 Median $120.23 Typical High $165.96 | Professional | 52 · Reduced service | $60.26 | $120.23 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $47.86 Typical High $66.07 | Professional | 53 · Discontinued | $23.99 | $47.86 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $177.83 Typical High $245.47 | Professional | 54 · Surgery only | $91.20 | $177.83 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $35.48 Typical High $48.98 | Professional | 55 · Aftercare only | $18.20 | $35.48 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $23.99 Typical High $33.11 | Professional | 56 · Pre-op care only | $12.02 | $23.99 | $33.11 |
Where Missouri sits
The same service costs 3.5 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
$309
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.