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 $794.33 Median $794.33 Typical High $933.25 | Facility | None | $794.33 | $794.33 | $933.25 |
Aetna Setting Professional Modifier None Typical Low $758.58 Median $794.33 Typical High $933.25 | Professional | None | $758.58 | $794.33 | $933.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $1,047.13 | Professional | None | $524.81 | $691.83 | $1,047.13 |
BCBS Kansas City Setting Professional Modifier None Typical Low $831.76 Median $891.25 Typical High $1,202.26 | Professional | None | $831.76 | $891.25 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $741.31 Typical High $1,318.26 | Professional | None | $676.08 | $741.31 | $1,318.26 |
Medica Setting Facility Modifier None Typical Low $776.25 Median $1,174.90 Typical High $3,467.37 | Facility | None | $776.25 | $1,174.90 | $3,467.37 |
Medica Setting Professional Modifier None Typical Low $602.56 Median $4,897.79 Typical High $5,370.32 | Professional | None | $602.56 | $4,897.79 | $5,370.32 |
United Setting Professional Modifier None Typical Low $588.84 Median $660.69 Typical High $1,071.52 | Professional | None | $588.84 | $660.69 | $1,071.52 |
4 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 $380.19 Median $398.11 Typical High $467.74 | Professional | 52 · Reduced service | $380.19 | $398.11 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $158.49 Typical High $186.21 | Professional | 53 · Discontinued | $151.36 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $120.23 Typical High $141.25 | Professional | 55 · Aftercare only | $114.82 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $79.43 Typical High $93.33 | Professional | 56 · Pre-op care only | $75.86 | $79.43 | $93.33 |
Where Missouri sits
The same service costs 3.2 times more in Alaska than in New York. 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· 40th of 51
$741
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.