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 $269.15 Median $3,162.28 Typical High $7,762.47 | Facility | None | $269.15 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $218.78 Typical High $269.15 | Professional | None | $97.72 | $218.78 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $724.44 Median $1,819.70 Typical High $3,981.07 | Facility | None | $724.44 | $1,819.70 | $3,981.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $114.82 Median $131.83 Typical High $234.42 | Professional | None | $114.82 | $131.83 | $234.42 |
BCBS Kansas City Setting Professional Modifier None Typical Low $107.15 Median $239.88 Typical High $323.59 | Professional | None | $107.15 | $239.88 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $257.04 Typical High $467.74 | Professional | None | $125.89 | $257.04 | $467.74 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $537.03 Typical High $2,344.23 | Facility | None | $54.95 | $537.03 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $338.84 Median $977.24 Typical High $2,454.71 | Professional | None | $338.84 | $977.24 | $2,454.71 |
United Setting Facility Modifier None Typical Low $891.25 Median $1,778.28 Typical High $2,951.21 | Facility | None | $891.25 | $1,778.28 | $2,951.21 |
United Setting Professional Modifier None Typical Low $144.54 Median $275.42 Typical High $501.19 | Professional | None | $144.54 | $275.42 | $501.19 |
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 $48.98 Median $104.71 Typical High $134.90 | Professional | 52 · Reduced service | $48.98 | $104.71 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $42.66 Typical High $53.70 | Professional | 53 · Discontinued | $19.95 | $42.66 | $53.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $158.49 Typical High $199.53 | Professional | 54 · Surgery only | $74.13 | $158.49 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $31.62 Typical High $39.81 | Professional | 55 · Aftercare only | $14.79 | $31.62 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $21.38 Typical High $26.92 | Professional | 56 · Pre-op care only | $9.77 | $21.38 | $26.92 |
Where Missouri sits
The same service costs 3.4 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
$251
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.