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 $1,659.59 Median $1,698.24 Typical High $1,698.24 | Facility | None | $1,659.59 | $1,698.24 | $1,698.24 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,698.24 Typical High $1,949.84 | Professional | None | $1,659.59 | $1,698.24 | $1,949.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $109.65 Typical High $1,230.27 | Professional | None | $97.72 | $109.65 | $1,230.27 |
BCBS Kansas City Setting Professional Modifier None Typical Low $120.23 Median $138.04 Typical High $181.97 | Professional | None | $120.23 | $138.04 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $190.55 Typical High $281.84 | Facility | None | $125.89 | $190.55 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Medica Setting Facility Modifier None Typical Low $1,288.25 Median $1,698.24 Typical High $5,495.41 | Facility | None | $1,288.25 | $1,698.24 | $5,495.41 |
Medica Setting Professional Modifier None Typical Low $1,479.11 Median $1,659.59 Typical High $5,888.44 | Professional | None | $1,479.11 | $1,659.59 | $5,888.44 |
United Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $147.91 | Professional | None | $114.82 | $125.89 | $147.91 |
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 $812.83 Median $851.14 Typical High $977.24 | Professional | 52 · Reduced service | $812.83 | $851.14 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $338.84 Typical High $398.11 | Professional | 53 · Discontinued | $331.13 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,258.93 Typical High $1,479.11 | Professional | 54 · Surgery only | $1,230.27 | $1,258.93 | $1,479.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $251.19 Typical High $295.12 | Professional | 55 · Aftercare only | $245.47 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $169.82 Typical High $194.98 | Professional | 56 · Pre-op care only | $165.96 | $169.82 | $194.98 |
Where Missouri sits
The same service costs 15.1 times more in Arkansas than in North Carolina. 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· 40th of 51
$126
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.