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 $125.89 Median $2,570.40 Typical High $6,309.57 | Facility | None | $125.89 | $2,570.40 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $199.53 | Professional | None | $89.13 | $125.89 | $199.53 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $245.47 | Professional | None | $144.54 | $144.54 | $245.47 |
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 $91.20 Median $112.20 Typical High $181.97 | Professional | None | $91.20 | $112.20 | $181.97 |
BCBS Kansas City Setting Professional Modifier None Typical Low $100.00 Median $158.49 Typical High $194.98 | Professional | None | $100.00 | $158.49 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $120.23 Typical High $575.44 | Facility | None | $66.07 | $120.23 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $239.88 | Professional | None | $112.20 | $147.91 | $239.88 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $489.78 Typical High $1,949.84 | Facility | None | $54.95 | $489.78 | $1,949.84 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $776.25 Typical High $1,122.02 | Professional | None | $169.82 | $776.25 | $1,122.02 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $2,238.72 | Facility | None | $398.11 | $1,148.15 | $2,238.72 |
United Setting Professional Modifier None Typical Low $112.20 Median $177.83 Typical High $281.84 | Professional | None | $112.20 | $177.83 | $281.84 |
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 $43.65 Median $63.10 Typical High $77.62 | Professional | 52 · Reduced service | $43.65 | $63.10 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $25.12 Typical High $30.90 | Professional | 53 · Discontinued | $17.78 | $25.12 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $93.33 Typical High $114.82 | Professional | 54 · Surgery only | $66.07 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $18.62 Typical High $22.91 | Professional | 55 · Aftercare only | $13.18 | $18.62 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $12.59 Typical High $15.49 | Professional | 56 · Pre-op care only | $8.91 | $12.59 | $15.49 |
Where Missouri sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 35th of 51
$158
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.