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 $83.18 Median $3,162.28 Typical High $6,309.57 | Facility | None | $83.18 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $67.61 Typical High $107.15 | Professional | None | $37.15 | $67.61 | $107.15 |
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 $75.86 Median $104.71 Typical High $154.88 | Professional | None | $75.86 | $104.71 | $154.88 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $114.82 Median $158.49 Typical High $234.42 | Professional | 50 · Both sides | $114.82 | $158.49 | $234.42 |
BCBS Kansas City Setting Professional Modifier None Typical Low $39.81 Median $77.62 Typical High $100.00 | Professional | None | $39.81 | $77.62 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $77.62 Typical High $1,659.59 | Facility | None | $51.29 | $77.62 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $89.13 Typical High $158.49 | Professional | None | $47.86 | $89.13 | $158.49 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $269.15 Typical High $1,288.25 | Facility | None | $54.95 | $269.15 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $74.13 Median $181.97 Typical High $1,023.29 | Professional | None | $74.13 | $181.97 | $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 $48.98 Median $107.15 Typical High $181.97 | Professional | None | $48.98 | $107.15 | $181.97 |
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 $18.62 Median $33.88 Typical High $41.69 | Professional | 52 · Reduced service | $18.62 | $33.88 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $13.49 Typical High $16.60 | Professional | 53 · Discontinued | $7.41 | $13.49 | $16.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $51.29 Typical High $63.10 | Professional | 54 · Surgery only | $28.18 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $10.23 Typical High $12.59 | Professional | 55 · Aftercare only | $5.62 | $10.23 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $6.76 Typical High $8.32 | Professional | 56 · Pre-op care only | $3.72 | $6.76 | $8.32 |
Where Missouri sits
The same service costs 3.0 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· 20th 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.