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 $275.42 Median $4,897.79 Typical High $7,762.47 | Facility | None | $275.42 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $144.54 Typical High $229.09 | Professional | None | $125.89 | $144.54 | $229.09 |
Ambetter Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
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 $85.11 Median $120.23 Typical High $223.87 | Professional | None | $85.11 | $120.23 | $223.87 |
BCBS Kansas City Setting Professional Modifier None Typical Low $123.03 Median $134.90 Typical High $158.49 | Professional | None | $123.03 | $134.90 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $457.09 Typical High $575.44 | Facility | None | $302.00 | $457.09 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $147.91 Typical High $239.88 | Professional | None | $109.65 | $147.91 | $239.88 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $380.19 Typical High $1,258.93 | Facility | None | $123.03 | $380.19 | $1,258.93 |
Medica Setting Professional Modifier None Typical Low $123.03 Median $302.00 Typical High $1,621.81 | Professional | None | $123.03 | $302.00 | $1,621.81 |
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 $107.15 Median $162.18 Typical High $316.23 | Professional | None | $107.15 | $162.18 | $316.23 |
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 $63.10 Median $72.44 Typical High $85.11 | Professional | 52 · Reduced service | $63.10 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $28.84 Typical High $33.88 | Professional | 53 · Discontinued | $25.12 | $28.84 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $107.15 Typical High $125.89 | Professional | 54 · Surgery only | $95.50 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $21.88 Typical High $25.12 | Professional | 55 · Aftercare only | $19.05 | $21.88 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $14.45 Typical High $16.98 | Professional | 56 · Pre-op care only | $12.59 | $14.45 | $16.98 |
Where Missouri sits
The same service costs 3.2 times more in Alaska 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· 33rd of 51
$148
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.