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 $38.90 Median $1,174.90 Typical High $6,309.57 | Facility | None | $38.90 | $1,174.90 | $6,309.57 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $72.44 Typical High $128.82 | Professional | None | $34.67 | $72.44 | $128.82 |
Ambetter Setting Professional Modifier None Typical Low $26.92 Median $61.66 Typical High $109.65 | Professional | None | $26.92 | $61.66 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.12 Median $57.54 Typical High $109.65 | Professional | None | $25.12 | $57.54 | $109.65 |
BCBS Kansas City Setting Professional Modifier None Typical Low $32.36 Median $95.50 Typical High $112.20 | Professional | None | $32.36 | $95.50 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $16.98 Median $38.90 Typical High $112.20 | Professional | None | $16.98 | $38.90 | $112.20 |
Medica Setting Facility Modifier None Typical Low $75.86 Median $245.47 Typical High $1,258.93 | Facility | None | $75.86 | $245.47 | $1,258.93 |
Medica Setting Professional Modifier None Typical Low $63.10 Median $380.19 Typical High $645.65 | Professional | None | $63.10 | $380.19 | $645.65 |
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 $24.55 Median $57.54 Typical High $100.00 | Professional | None | $24.55 | $57.54 | $100.00 |
3 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 54 · Surgery only Typical Low $26.30 Median $33.11 Typical High $91.20 | Professional | 54 · Surgery only | $26.30 | $33.11 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $6.61 Typical High $18.20 | Professional | 55 · Aftercare only | $5.25 | $6.61 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $4.47 Typical High $12.30 | Professional | 56 · Pre-op care only | $3.47 | $4.47 | $12.30 |
Where Missouri sits
The same service costs 2.8 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· 39th of 51
$67.61
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.