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 $154.88 Median $173.78 Typical High $363.08 | Facility | None | $154.88 | $173.78 | $363.08 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $165.96 Typical High $190.55 | Professional | None | $154.88 | $165.96 | $190.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,659.59 | Facility | None | $1,479.11 | $1,479.11 | $1,659.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $79.43 Median $223.87 Typical High $323.59 | Professional | None | $79.43 | $223.87 | $323.59 |
BCBS Kansas City Setting Professional Modifier None Typical Low $165.96 Median $186.21 Typical High $251.19 | Professional | None | $165.96 | $186.21 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $1,000.00 | Facility | None | $630.96 | $630.96 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $186.21 Typical High $346.74 | Professional | None | $162.18 | $186.21 | $346.74 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $316.23 Typical High $1,000.00 | Facility | None | $190.55 | $316.23 | $1,000.00 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $1,122.02 Typical High $1,122.02 | Professional | None | $177.83 | $1,122.02 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,096.48 | Facility | None | $1,047.13 | $1,047.13 | $1,096.48 |
United Setting Professional Modifier None Typical Low $158.49 Median $208.93 Typical High $275.42 | Professional | None | $158.49 | $208.93 | $275.42 |
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 $77.62 Median $83.18 Typical High $95.50 | Professional | 52 · Reduced service | $77.62 | $83.18 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $33.88 Typical High $38.02 | Professional | 53 · Discontinued | $30.90 | $33.88 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $25.12 Typical High $28.84 | Professional | 55 · Aftercare only | $22.91 | $25.12 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $16.60 Typical High $19.05 | Professional | 56 · Pre-op care only | $15.49 | $16.60 | $19.05 |
Where Missouri sits
The same service costs 2.9 times more in Alaska than in Florida. 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· 29th of 51
$214
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.