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 $64.57 Median $4,677.35 Typical High $7,762.47 | Facility | None | $64.57 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $64.57 Typical High $74.13 | Professional | None | $48.98 | $64.57 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $1,621.81 Typical High $3,890.45 | Facility | None | $151.36 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $72.44 Typical High $91.20 | Professional | None | $52.48 | $72.44 | $91.20 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $77.62 Median $107.15 Typical High $138.04 | Professional | 50 · Both sides | $77.62 | $107.15 | $138.04 |
BCBS Kansas City Setting Professional Modifier None Typical Low $41.69 Median $61.66 Typical High $72.44 | Professional | None | $41.69 | $61.66 | $72.44 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $45.71 Typical High $66.07 | Facility | None | $32.36 | $45.71 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $60.26 Typical High $102.33 | Professional | None | $45.71 | $60.26 | $102.33 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $245.47 Typical High $1,288.25 | Facility | None | $54.95 | $245.47 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $60.26 Median $436.52 Typical High $1,862.09 | Professional | None | $60.26 | $436.52 | $1,862.09 |
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 $50.12 Median $66.07 Typical High $104.71 | Professional | None | $50.12 | $66.07 | $104.71 |
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 $30.90 Typical High $37.15 | Professional | 52 · Reduced service | $24.55 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $12.30 Typical High $14.79 | Professional | 53 · Discontinued | $9.77 | $12.30 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $36.31 Median $45.71 Typical High $56.23 | Professional | 54 · Surgery only | $36.31 | $45.71 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $9.12 Typical High $11.22 | Professional | 55 · Aftercare only | $7.24 | $9.12 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $6.17 Typical High $7.41 | Professional | 56 · Pre-op care only | $4.90 | $6.17 | $7.41 |
Where Missouri sits
The same service costs 3.7 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· 31st of 51
$72.44
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.