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 $57.54 Median $3,162.28 Typical High $6,309.57 | Facility | None | $57.54 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $56.23 Typical High $79.43 | Professional | None | $48.98 | $56.23 | $79.43 |
Ambetter Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
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 $66.07 Median $77.62 Typical High $117.49 | Professional | None | $66.07 | $77.62 | $117.49 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $100.00 Median $114.82 Typical High $177.83 | Professional | 50 · Both sides | $100.00 | $114.82 | $177.83 |
BCBS Kansas City Setting Professional Modifier None Typical Low $39.81 Median $52.48 Typical High $61.66 | Professional | None | $39.81 | $52.48 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $38.02 Typical High $1,659.59 | Facility | None | $25.12 | $38.02 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $61.66 Typical High $134.90 | Professional | None | $45.71 | $61.66 | $134.90 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $263.03 Typical High $1,288.25 | Facility | None | $54.95 | $263.03 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $75.86 Median $380.19 Typical High $426.58 | Professional | None | $75.86 | $380.19 | $426.58 |
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 $58.88 Median $89.13 Typical High $109.65 | Professional | None | $58.88 | $89.13 | $109.65 |
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 $24.55 Median $26.92 Typical High $30.90 | Professional | 52 · Reduced service | $24.55 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $10.72 Typical High $12.30 | Professional | 53 · Discontinued | $9.77 | $10.72 | $12.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $39.81 Typical High $46.77 | Professional | 54 · Surgery only | $36.31 | $39.81 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.94 Typical High $9.33 | Professional | 55 · Aftercare only | $7.24 | $7.94 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.37 Typical High $6.17 | Professional | 56 · Pre-op care only | $4.90 | $5.37 | $6.17 |
Where Missouri sits
The same service costs 3.6 times more in Wyoming 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· 18th of 51
$89.13
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.