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 $58.88 Median $1,819.70 Typical High $6,309.57 | Facility | None | $58.88 | $1,819.70 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $93.33 Typical High $147.91 | Professional | None | $41.69 | $93.33 | $147.91 |
Ambetter Setting Professional Modifier None Typical Low $54.95 Median $72.44 Typical High $72.44 | Professional | None | $54.95 | $72.44 | $72.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $1,621.81 Typical High $3,890.45 | Facility | None | $151.36 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $83.18 Typical High $102.33 | Professional | None | $67.61 | $83.18 | $102.33 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $100.00 Median $123.03 Typical High $154.88 | Professional | 50 · Both sides | $100.00 | $123.03 | $154.88 |
BCBS Kansas City Setting Professional Modifier None Typical Low $48.98 Median $117.49 Typical High $147.91 | Professional | None | $48.98 | $117.49 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $134.90 Typical High $1,659.59 | Facility | None | $89.13 | $134.90 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $93.33 Typical High $177.83 | Professional | None | $54.95 | $93.33 | $177.83 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $239.88 Typical High $1,288.25 | Facility | None | $54.95 | $239.88 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $123.03 Median $812.83 Typical High $1,023.29 | Professional | None | $123.03 | $812.83 | $1,023.29 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,137.96 | Facility | None | $123.03 | $602.56 | $2,137.96 |
United Setting Professional Modifier None Typical Low $56.23 Median $117.49 Typical High $199.53 | Professional | None | $56.23 | $117.49 | $199.53 |
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 $20.89 Median $43.65 Typical High $57.54 | Professional | 52 · Reduced service | $20.89 | $43.65 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $17.38 Typical High $22.91 | Professional | 53 · Discontinued | $8.32 | $17.38 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $64.57 Typical High $85.11 | Professional | 54 · Surgery only | $31.62 | $64.57 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $12.88 Typical High $16.98 | Professional | 55 · Aftercare only | $6.31 | $12.88 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $8.71 Typical High $11.48 | Professional | 56 · Pre-op care only | $4.17 | $8.71 | $11.48 |
Where Missouri sits
The same service costs 3.4 times more in Alaska than in Kentucky. 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· 34th of 51
$107
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.