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 $46.77 Median $2,511.89 Typical High $7,762.47 | Facility | None | $46.77 | $2,511.89 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $63.10 Typical High $74.13 | Professional | None | $42.66 | $63.10 | $74.13 |
Ambetter Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $204.17 Median $3,467.37 Typical High $7,079.46 | Facility | None | $204.17 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $58.88 Typical High $79.43 | Professional | None | $42.66 | $58.88 | $79.43 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $63.10 Median $89.13 Typical High $117.49 | Professional | 50 · Both sides | $63.10 | $89.13 | $117.49 |
BCBS Kansas City Setting Professional Modifier None Typical Low $38.90 Median $63.10 Typical High $70.79 | Professional | None | $38.90 | $63.10 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $66.07 | Facility | None | $50.12 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $58.88 Typical High $95.50 | Professional | None | $39.81 | $58.88 | $95.50 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $245.47 Typical High $2,041.74 | Facility | None | $54.95 | $245.47 | $2,041.74 |
Medica Setting Professional Modifier None Typical Low $54.95 Median $707.95 Typical High $1,949.84 | Professional | None | $54.95 | $707.95 | $1,949.84 |
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 $38.90 Median $57.54 Typical High $100.00 | Professional | None | $38.90 | $57.54 | $100.00 |
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 $21.38 Median $30.20 Typical High $36.31 | Professional | 52 · Reduced service | $21.38 | $30.20 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $12.02 Typical High $14.45 | Professional | 53 · Discontinued | $8.51 | $12.02 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $45.71 Typical High $54.95 | Professional | 54 · Surgery only | $32.36 | $45.71 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $9.12 Typical High $10.96 | Professional | 55 · Aftercare only | $6.46 | $9.12 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $6.03 Typical High $7.24 | Professional | 56 · Pre-op care only | $4.27 | $6.03 | $7.24 |
Where Missouri sits
The same service costs 3.8 times more in Alaska than in Maryland. 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· 23rd of 51
$70.79
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.