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 $1,548.82 Median $3,981.07 Typical High $7,762.47 | Facility | None | $1,548.82 | $3,981.07 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $177.83 Typical High $223.87 | Professional | None | $151.36 | $177.83 | $223.87 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $346.74 | Professional | None | $186.21 | $234.42 | $346.74 |
BCBS Kansas City Setting Professional Modifier None Typical Low $158.49 Median $169.82 Typical High $218.78 | Professional | None | $158.49 | $169.82 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $2,137.96 Typical High $2,691.53 | Facility | None | $512.86 | $2,137.96 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $194.98 Typical High $346.74 | Professional | None | $147.91 | $194.98 | $346.74 |
Medica Setting Facility Modifier None Typical Low $131.83 Median $575.44 Typical High $16,218.10 | Facility | None | $131.83 | $575.44 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $338.84 Typical High $1,318.26 | Professional | None | $194.98 | $338.84 | $1,318.26 |
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 $162.18 Median $288.40 Typical High $380.19 | Professional | None | $162.18 | $288.40 | $380.19 |
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 $74.13 Median $89.13 Typical High $93.33 | Professional | 52 · Reduced service | $74.13 | $89.13 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $35.48 Typical High $37.15 | Professional | 53 · Discontinued | $30.20 | $35.48 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $134.90 Typical High $138.04 | Professional | 54 · Surgery only | $112.20 | $134.90 | $138.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $26.92 Typical High $27.54 | Professional | 55 · Aftercare only | $22.39 | $26.92 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $17.78 Typical High $18.62 | Professional | 56 · Pre-op care only | $15.14 | $17.78 | $18.62 |
Where Missouri sits
The same service costs 4.5 times more in Alaska than in New York. 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· 15th of 51
$282
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.