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 $22.91 Median $4,677.35 Typical High $7,762.47 | Facility | None | $22.91 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $22.91 Typical High $42.66 | Professional | None | $19.95 | $22.91 | $42.66 |
Ambetter Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
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 $36.31 Median $60.26 Typical High $87.10 | Professional | None | $36.31 | $60.26 | $87.10 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $53.70 Median $91.20 Typical High $131.83 | Professional | 50 · Both sides | $53.70 | $91.20 | $131.83 |
BCBS Kansas City Setting Professional Modifier None Typical Low $19.05 Median $19.95 Typical High $29.51 | Professional | None | $19.05 | $19.95 | $29.51 |
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 $18.20 Median $24.55 Typical High $67.61 | Professional | None | $18.20 | $24.55 | $67.61 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $223.87 Typical High $1,288.25 | Facility | None | $54.95 | $223.87 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $34.67 Median $302.00 Typical High $645.65 | Professional | None | $34.67 | $302.00 | $645.65 |
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 $26.30 Median $46.77 Typical High $56.23 | Professional | None | $26.30 | $46.77 | $56.23 |
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 $10.00 Median $11.22 Typical High $13.18 | Professional | 52 · Reduced service | $10.00 | $11.22 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $4.57 Typical High $5.25 | Professional | 53 · Discontinued | $3.98 | $4.57 | $5.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.79 Median $16.98 Typical High $19.95 | Professional | 54 · Surgery only | $14.79 | $16.98 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.02 Median $3.39 Typical High $3.98 | Professional | 55 · Aftercare only | $3.02 | $3.39 | $3.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $2.29 Typical High $2.63 | Professional | 56 · Pre-op care only | $2.00 | $2.29 | $2.63 |
Where Missouri sits
The same service costs 4.3 times more in Wyoming 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· 11th of 51
$52.48
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.