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 $186.21 Median $3,162.28 Typical High $7,762.47 | Facility | None | $186.21 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $151.36 Typical High $186.21 | Professional | None | $112.20 | $151.36 | $186.21 |
Ambetter Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
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 $117.49 Median $141.25 Typical High $229.09 | Professional | None | $117.49 | $141.25 | $229.09 |
BCBS Kansas City Setting Professional Modifier None Typical Low $120.23 Median $186.21 Typical High $229.09 | Professional | None | $120.23 | $186.21 | $229.09 |
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 $141.25 Median $181.97 Typical High $295.12 | Professional | None | $141.25 | $181.97 | $295.12 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $549.54 Typical High $1,949.84 | Facility | None | $54.95 | $549.54 | $1,949.84 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $954.99 Typical High $1,348.96 | Professional | None | $208.93 | $954.99 | $1,348.96 |
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 $138.04 Median $223.87 Typical High $338.84 | Professional | None | $138.04 | $223.87 | $338.84 |
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 $54.95 Median $75.86 Typical High $93.33 | Professional | 52 · Reduced service | $54.95 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $30.20 Typical High $37.15 | Professional | 53 · Discontinued | $22.39 | $30.20 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $114.82 Typical High $141.25 | Professional | 54 · Surgery only | $83.18 | $114.82 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $22.91 Typical High $28.18 | Professional | 55 · Aftercare only | $16.60 | $22.91 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $15.14 Typical High $18.62 | Professional | 56 · Pre-op care only | $11.22 | $15.14 | $18.62 |
Where Missouri sits
The same service costs 3.6 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· 33rd of 51
$191
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.