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 $389.05 Median $478.63 Typical High $660.69 | Facility | None | $389.05 | $478.63 | $660.69 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $426.58 Typical High $489.78 | Professional | None | $407.38 | $426.58 | $489.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $407.38 Median $549.54 Typical High $1,380.38 | Facility | None | $407.38 | $549.54 | $1,380.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $478.63 Typical High $478.63 | Professional | None | $398.11 | $478.63 | $478.63 |
BCBS Kansas City Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $812.83 | Professional | None | $446.68 | $446.68 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $524.81 | Professional | None | $416.87 | $416.87 | $524.81 |
Medica Setting Facility Modifier None Typical Low $346.74 Median $416.87 Typical High $1,819.70 | Facility | None | $346.74 | $416.87 | $1,819.70 |
Medica Setting Professional Modifier None Typical Low $380.19 Median $1,584.89 Typical High $1,584.89 | Professional | None | $380.19 | $1,584.89 | $1,584.89 |
United Setting Facility Modifier None Typical Low $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
United Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $457.09 | Professional | None | $354.81 | $416.87 | $457.09 |
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 $204.17 Median $213.80 Typical High $245.47 | Professional | 52 · Reduced service | $204.17 | $213.80 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $85.11 Typical High $97.72 | Professional | 53 · Discontinued | $81.28 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $63.10 Typical High $74.13 | Professional | 55 · Aftercare only | $61.66 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $42.66 Typical High $48.98 | Professional | 56 · Pre-op care only | $40.74 | $42.66 | $48.98 |
Where Missouri sits
The same service costs 1.5 times more in Alaska than in Oklahoma. 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· 8th of 51
$427
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.