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 $63.10 Median $147.91 Typical High $147.91 | Facility | None | $63.10 | $147.91 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $89.13 Typical High $147.91 | Professional | None | $63.10 | $89.13 | $147.91 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $83.18 Typical High $120.23 | Professional | None | $60.26 | $83.18 | $120.23 |
BCBS Kansas City Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $151.36 | Professional | None | $91.20 | $91.20 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Medica Setting Facility Modifier None Typical Low $79.43 Median $302.00 Typical High $691.83 | Facility | None | $79.43 | $302.00 | $691.83 |
Medica Setting Professional Modifier None Typical Low $52.48 Median $74.13 Typical High $1,288.25 | Professional | None | $52.48 | $74.13 | $1,288.25 |
United Setting Professional Modifier None Typical Low $48.98 Median $74.13 Typical High $120.23 | Professional | None | $48.98 | $74.13 | $120.23 |
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 $31.62 Median $44.67 Typical High $74.13 | Professional | 52 · Reduced service | $31.62 | $44.67 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $17.78 Typical High $29.51 | Professional | 53 · Discontinued | $12.59 | $17.78 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $67.61 Typical High $109.65 | Professional | 54 · Surgery only | $47.86 | $67.61 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $13.49 Typical High $21.88 | Professional | 55 · Aftercare only | $9.55 | $13.49 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $8.91 Typical High $14.79 | Professional | 56 · Pre-op care only | $6.31 | $8.91 | $14.79 |
Where Missouri sits
The same service costs 2.8 times more in Hawaii than in New York. 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
$83.18
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.