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 $42.66 Median $4,677.35 Typical High $7,762.47 | Facility | None | $42.66 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $42.66 Typical High $50.12 | Professional | None | $34.67 | $42.66 | $50.12 |
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 $36.31 Median $48.98 Typical High $60.26 | Professional | None | $36.31 | $48.98 | $60.26 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $54.95 Median $72.44 Typical High $91.20 | Professional | 50 · Both sides | $54.95 | $72.44 | $91.20 |
BCBS Kansas City Setting Professional Modifier None Typical Low $29.51 Median $40.74 Typical High $47.86 | Professional | None | $29.51 | $40.74 | $47.86 |
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 $33.11 Median $39.81 Typical High $70.79 | Professional | None | $33.11 | $39.81 | $70.79 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $239.88 Typical High $1,513.56 | Facility | None | $54.95 | $239.88 | $1,513.56 |
Medica Setting Professional Modifier None Typical Low $38.90 Median $416.87 Typical High $812.83 | Professional | None | $38.90 | $416.87 | $812.83 |
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 $32.36 Median $42.66 Typical High $70.79 | Professional | None | $32.36 | $42.66 | $70.79 |
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 $17.38 Median $20.42 Typical High $25.12 | Professional | 52 · Reduced service | $17.38 | $20.42 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $8.32 Typical High $10.00 | Professional | 53 · Discontinued | $6.92 | $8.32 | $10.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.30 Median $30.90 Typical High $37.15 | Professional | 54 · Surgery only | $26.30 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $6.17 Typical High $7.41 | Professional | 55 · Aftercare only | $5.25 | $6.17 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $4.07 Typical High $5.01 | Professional | 56 · Pre-op care only | $3.47 | $4.07 | $5.01 |
Where Missouri sits
The same service costs 3.8 times more in Alaska than in Utah. 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
$53.70
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.