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 $56.23 Median $4,570.88 Typical High $7,762.47 | Facility | None | $56.23 | $4,570.88 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $69.18 Typical High $81.28 | Professional | None | $51.29 | $69.18 | $81.28 |
Ambetter Setting Professional Modifier None Typical Low $52.48 Median $61.66 Typical High $83.18 | Professional | None | $52.48 | $61.66 | $83.18 |
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 $54.95 Median $70.79 Typical High $95.50 | Professional | None | $54.95 | $70.79 | $95.50 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $81.28 Median $107.15 Typical High $144.54 | Professional | 50 · Both sides | $81.28 | $107.15 | $144.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $43.65 Median $66.07 Typical High $75.86 | Professional | None | $43.65 | $66.07 | $75.86 |
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 $48.98 Median $66.07 Typical High $107.15 | Professional | None | $48.98 | $66.07 | $107.15 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $245.47 Typical High $1,380.38 | Facility | None | $54.95 | $245.47 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $69.18 Median $380.19 Typical High $912.01 | Professional | None | $69.18 | $380.19 | $912.01 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $2,137.96 | Facility | None | $123.03 | $537.03 | $2,137.96 |
United Setting Professional Modifier None Typical Low $53.70 Median $74.13 Typical High $114.82 | Professional | None | $53.70 | $74.13 | $114.82 |
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 $25.70 Median $33.11 Typical High $40.74 | Professional | 52 · Reduced service | $25.70 | $33.11 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $13.49 Typical High $16.22 | Professional | 53 · Discontinued | $10.23 | $13.49 | $16.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $50.12 Typical High $60.26 | Professional | 54 · Surgery only | $38.90 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $10.00 Typical High $12.02 | Professional | 55 · Aftercare only | $7.76 | $10.00 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $6.61 Typical High $8.13 | Professional | 56 · Pre-op care only | $5.13 | $6.61 | $8.13 |
Where Missouri sits
The same service costs 3.6 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· 22nd of 51
$81.28
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.