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 $48.98 Median $112.20 Typical High $7,762.47 | Facility | None | $48.98 | $112.20 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $70.79 Typical High $112.20 | Professional | None | $41.69 | $70.79 | $112.20 |
Ambetter Setting Professional Modifier None Typical Low $63.10 Median $123.03 Typical High $123.03 | Professional | None | $63.10 | $123.03 | $123.03 |
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 $51.29 Median $67.61 Typical High $97.72 | Professional | None | $51.29 | $67.61 | $97.72 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $75.86 Median $102.33 Typical High $144.54 | Professional | 50 · Both sides | $75.86 | $102.33 | $144.54 |
BCBS Kansas City Setting Professional Modifier None Typical Low $43.65 Median $79.43 Typical High $120.23 | Professional | None | $43.65 | $79.43 | $120.23 |
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 $46.77 Median $83.18 Typical High $181.97 | Professional | None | $46.77 | $83.18 | $181.97 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $251.19 Typical High $1,380.38 | Facility | None | $54.95 | $251.19 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $95.50 Median $380.19 Typical High $645.65 | Professional | None | $95.50 | $380.19 | $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 $56.23 Median $95.50 Typical High $162.18 | Professional | None | $56.23 | $95.50 | $162.18 |
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 $20.89 Median $35.48 Typical High $40.74 | Professional | 52 · Reduced service | $20.89 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $14.13 Typical High $16.60 | Professional | 53 · Discontinued | $8.32 | $14.13 | $16.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $52.48 Typical High $61.66 | Professional | 54 · Surgery only | $31.62 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $10.47 Typical High $12.30 | Professional | 55 · Aftercare only | $6.31 | $10.47 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $7.08 Typical High $8.13 | Professional | 56 · Pre-op care only | $4.17 | $7.08 | $8.13 |
Where Missouri sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 37th of 51
$85.11
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.