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 $69.18 Median $4,677.35 Typical High $7,762.47 | Facility | None | $69.18 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $69.18 Typical High $112.20 | Professional | None | $45.71 | $69.18 | $112.20 |
Ambetter Setting Professional Modifier None Typical Low $102.33 Median $104.71 Typical High $123.03 | Professional | None | $102.33 | $104.71 | $123.03 |
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 $57.54 Median $87.10 Typical High $144.54 | Professional | None | $57.54 | $87.10 | $144.54 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $87.10 Median $128.82 Typical High $218.78 | Professional | 50 · Both sides | $87.10 | $128.82 | $218.78 |
BCBS Kansas City Setting Professional Modifier None Typical Low $46.77 Median $79.43 Typical High $120.23 | Professional | None | $46.77 | $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 $50.12 Median $81.28 Typical High $194.98 | Professional | None | $50.12 | $81.28 | $194.98 |
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 $93.33 Median $380.19 Typical High $660.69 | Professional | None | $93.33 | $380.19 | $660.69 |
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 $60.26 Median $93.33 Typical High $165.96 | Professional | None | $60.26 | $93.33 | $165.96 |
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 $22.91 Median $34.67 Typical High $39.81 | Professional | 52 · Reduced service | $22.91 | $34.67 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $13.80 Typical High $16.22 | Professional | 53 · Discontinued | $9.12 | $13.80 | $16.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $51.29 Typical High $60.26 | Professional | 54 · Surgery only | $33.88 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $10.47 Typical High $12.02 | Professional | 55 · Aftercare only | $6.76 | $10.47 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $6.92 Typical High $7.94 | Professional | 56 · Pre-op care only | $4.57 | $6.92 | $7.94 |
Where Missouri sits
The same service costs 3.2 times more in Wisconsin 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· 28th of 51
$97.72
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.