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 $812.83 Median $3,162.28 Typical High $7,762.47 | Facility | None | $812.83 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $144.54 Typical High $218.78 | Professional | None | $56.23 | $144.54 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $102.33 Typical High $223.87 | Professional | None | $63.10 | $102.33 | $223.87 |
BCBS Kansas City Setting Professional Modifier None Typical Low $48.98 Median $141.25 Typical High $162.18 | Professional | None | $48.98 | $141.25 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $575.44 | Facility | None | $239.88 | $239.88 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $144.54 Typical High $257.04 | Professional | None | $69.18 | $144.54 | $257.04 |
Medica Setting Facility Modifier None Typical Low $91.20 Median $223.87 Typical High $562.34 | Facility | None | $91.20 | $223.87 | $562.34 |
Medica Setting Professional Modifier None Typical Low $162.18 Median $416.87 Typical High $1,230.27 | Professional | None | $162.18 | $416.87 | $1,230.27 |
United Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $660.69 | Facility | None | $630.96 | $630.96 | $660.69 |
United Setting Professional Modifier None Typical Low $64.57 Median $165.96 Typical High $281.84 | Professional | None | $64.57 | $165.96 | $281.84 |
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 $28.18 Median $54.95 Typical High $104.71 | Professional | 52 · Reduced service | $28.18 | $54.95 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $21.88 Typical High $41.69 | Professional | 53 · Discontinued | $11.48 | $21.88 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $83.18 Typical High $154.88 | Professional | 54 · Surgery only | $42.66 | $83.18 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $16.60 Typical High $30.90 | Professional | 55 · Aftercare only | $8.51 | $16.60 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $10.96 Typical High $20.89 | Professional | 56 · Pre-op care only | $5.62 | $10.96 | $20.89 |
Where Missouri sits
The same service costs 3.5 times more in Alaska than in Maryland. 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· 35th of 51
$145
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.