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 $19.05 Median $3,162.28 Typical High $6,309.57 | Facility | None | $19.05 | $3,162.28 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $13.49 Median $15.49 Typical High $30.20 | Professional | None | $13.49 | $15.49 | $30.20 |
Ambetter Setting Professional Modifier None Typical Low $12.59 Median $21.38 Typical High $25.12 | Professional | None | $12.59 | $21.38 | $25.12 |
Ambetter Setting Professional Modifier 50 · Both sides Typical Low $17.38 Median $31.62 Typical High $33.11 | Professional | 50 · Both sides | $17.38 | $31.62 | $33.11 |
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 $10.96 Median $13.80 Typical High $26.30 | Professional | None | $10.96 | $13.80 | $26.30 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $16.60 Median $21.38 Typical High $39.81 | Professional | 50 · Both sides | $16.60 | $21.38 | $39.81 |
BCBS Kansas City Setting Professional Modifier None Typical Low $16.22 Median $17.78 Typical High $25.70 | Professional | None | $16.22 | $17.78 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $66.07 Typical High $1,096.48 | Facility | None | $58.88 | $66.07 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $13.80 Median $16.22 Typical High $34.67 | Professional | None | $13.80 | $16.22 | $34.67 |
Medica Setting Facility Modifier None Typical Low $34.67 Median $177.83 Typical High $1,096.48 | Facility | None | $34.67 | $177.83 | $1,096.48 |
Medica Setting Professional Modifier None Typical Low $12.88 Median $25.12 Typical High $117.49 | Professional | None | $12.88 | $25.12 | $117.49 |
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 $12.88 Median $18.20 Typical High $30.90 | Professional | None | $12.88 | $18.20 | $30.90 |
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 $6.76 Median $6.76 Typical High $8.13 | Professional | 52 · Reduced service | $6.76 | $6.76 | $8.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $2.69 Typical High $3.24 | Professional | 53 · Discontinued | $2.69 | $2.69 | $3.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.00 Median $10.00 Typical High $12.30 | Professional | 54 · Surgery only | $10.00 | $10.00 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $2.00 Typical High $2.45 | Professional | 55 · Aftercare only | $2.00 | $2.00 | $2.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $1.35 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.35 | $1.35 | $1.62 |
Where Missouri sits
The same service costs 7.4 times more in Kansas 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· 41st of 51
$18.62
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.