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 $234.42 Median $5,623.41 Typical High $8,709.64 | Facility | None | $234.42 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $194.98 Typical High $295.12 | Professional | None | $109.65 | $194.98 | $295.12 |
Ambetter Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $331.13 | Professional | None | $251.19 | $331.13 | $331.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,288.25 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,288.25 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $138.04 Median $234.42 Typical High $1,096.48 | Professional | None | $138.04 | $234.42 | $1,096.48 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $208.93 Median $354.81 Typical High $1,621.81 | Professional | 50 · Both sides | $208.93 | $354.81 | $1,621.81 |
BCBS Kansas City Setting Professional Modifier None Typical Low $112.20 Median $218.78 Typical High $295.12 | Professional | None | $112.20 | $218.78 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $218.78 Typical High $3,801.89 | Facility | None | $144.54 | $218.78 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $223.87 Typical High $436.52 | Professional | None | $123.03 | $223.87 | $436.52 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $1,445.44 Typical High $26,302.68 | Facility | None | $446.68 | $1,445.44 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $5,754.40 Typical High $6,456.54 | Professional | None | $218.78 | $5,754.40 | $6,456.54 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,235.94 | Facility | None | $562.34 | $1,513.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $147.91 Median $239.88 Typical High $489.78 | Professional | None | $147.91 | $239.88 | $489.78 |
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 $54.95 Median $91.20 Typical High $117.49 | Professional | 52 · Reduced service | $54.95 | $91.20 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $36.31 Typical High $46.77 | Professional | 53 · Discontinued | $21.88 | $36.31 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $138.04 Typical High $177.83 | Professional | 54 · Surgery only | $83.18 | $138.04 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $27.54 Typical High $35.48 | Professional | 55 · Aftercare only | $16.60 | $27.54 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $18.20 Typical High $23.44 | Professional | 56 · Pre-op care only | $10.96 | $18.20 | $23.44 |
Where Missouri sits
The same service costs 3.2 times more in Oklahoma than in Texas. 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· 24th of 51
$288
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.