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 $117.49 Median $3,162.28 Typical High $6,309.57 | Facility | None | $117.49 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $100.00 Typical High $134.90 | Professional | None | $67.61 | $100.00 | $134.90 |
Ambetter Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
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 $70.79 Median $87.10 Typical High $141.25 | Professional | None | $70.79 | $87.10 | $141.25 |
BCBS Kansas City Setting Professional Modifier None Typical Low $74.13 Median $125.89 Typical High $154.88 | Professional | None | $74.13 | $125.89 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,137.96 Typical High $2,691.53 | Facility | None | $575.44 | $2,137.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $117.49 Typical High $186.21 | Professional | None | $87.10 | $117.49 | $186.21 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $245.47 Typical High $1,071.52 | Facility | None | $54.95 | $245.47 | $1,071.52 |
Medica Setting Professional Modifier None Typical Low $138.04 Median $588.84 Typical High $891.25 | Professional | None | $138.04 | $588.84 | $891.25 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $2,137.96 | Facility | None | $123.03 | $549.54 | $2,137.96 |
United Setting Professional Modifier None Typical Low $87.10 Median $141.25 Typical High $223.87 | Professional | None | $87.10 | $141.25 | $223.87 |
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 $33.88 Median $50.12 Typical High $61.66 | Professional | 52 · Reduced service | $33.88 | $50.12 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $19.95 Typical High $24.55 | Professional | 53 · Discontinued | $13.49 | $19.95 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $74.13 Typical High $91.20 | Professional | 54 · Surgery only | $51.29 | $74.13 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $15.14 Typical High $18.62 | Professional | 55 · Aftercare only | $10.23 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $10.00 Typical High $12.30 | Professional | 56 · Pre-op care only | $6.76 | $10.00 | $12.30 |
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· 34th of 51
$123
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.