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 $2,630.27 Median $2,951.21 Typical High $4,168.69 | Facility | None | $2,630.27 | $2,951.21 | $4,168.69 |
Aetna Setting Professional Modifier None Typical Low $2,570.40 Median $2,630.27 Typical High $3,019.95 | Professional | None | $2,570.40 | $2,630.27 | $3,019.95 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $3,467.37 Typical High $8,511.38 | Facility | None | $2,570.40 | $3,467.37 | $8,511.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $2,454.71 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,454.71 | $2,951.21 | $2,951.21 |
BCBS Kansas City Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $5,011.87 | Professional | None | $2,818.38 | $2,818.38 | $5,011.87 |
Cigna Setting Facility Modifier None Typical Low $2,884.03 Median $3,090.30 Typical High $7,413.10 | Facility | None | $2,884.03 | $3,090.30 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
Medica Setting Facility Modifier None Typical Low $2,344.23 Median $2,818.38 Typical High $12,302.69 | Facility | None | $2,344.23 | $2,818.38 | $12,302.69 |
Medica Setting Professional Modifier None Typical Low $2,454.71 Median $10,715.19 Typical High $10,715.19 | Professional | None | $2,454.71 | $10,715.19 | $10,715.19 |
United Setting Facility Modifier None Typical Low $2,570.40 Median $2,570.40 Typical High $2,570.40 | Facility | None | $2,570.40 | $2,570.40 | $2,570.40 |
United Setting Professional Modifier None Typical Low $2,187.76 Median $2,570.40 Typical High $2,884.03 | Professional | None | $2,187.76 | $2,570.40 | $2,884.03 |
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 $1,258.93 Median $1,318.26 Typical High $1,513.56 | Professional | 52 · Reduced service | $1,258.93 | $1,318.26 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $512.86 Median $524.81 Typical High $616.60 | Professional | 53 · Discontinued | $512.86 | $524.81 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,905.46 Median $1,949.84 Typical High $2,290.87 | Professional | 54 · Surgery only | $1,905.46 | $1,949.84 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $380.19 Median $389.05 Typical High $457.09 | Professional | 55 · Aftercare only | $380.19 | $389.05 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $257.04 Median $263.03 Typical High $302.00 | Professional | 56 · Pre-op care only | $257.04 | $263.03 | $302.00 |
Where Missouri sits
Rates are fairly even across states for this service. 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· 34th of 51
$2,570
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.