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 $1,548.82 Median $3,981.07 Typical High $7,762.47 | Facility | None | $1,548.82 | $3,981.07 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $354.81 Typical High $2,187.76 | Professional | None | $223.87 | $354.81 | $2,187.76 |
Anthem BCBS Setting Professional Modifier None Typical Low $371.54 Median $436.52 Typical High $630.96 | Professional | None | $371.54 | $436.52 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,445.44 Typical High $5,248.07 | Facility | None | $707.95 | $1,445.44 | $5,248.07 |
Medica Setting Facility Modifier None Typical Low $524.81 Median $1,445.44 Typical High $5,623.41 | Facility | None | $524.81 | $1,445.44 | $5,623.41 |
Medica Setting Professional Modifier None Typical Low $575.44 Median $1,000.00 Typical High $2,570.40 | Professional | None | $575.44 | $1,000.00 | $2,570.40 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,235.94 | Facility | None | $562.34 | $1,513.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $467.74 Median $741.31 Typical High $1,230.27 | Professional | None | $467.74 | $741.31 | $1,230.27 |
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 $112.20 Median $165.96 Typical High $218.78 | Professional | 52 · Reduced service | $112.20 | $165.96 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $66.07 Typical High $89.13 | Professional | 53 · Discontinued | $44.67 | $66.07 | $89.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $251.19 Typical High $331.13 | Professional | 54 · Surgery only | $165.96 | $251.19 | $331.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.88 Median $50.12 Typical High $66.07 | Professional | 55 · Aftercare only | $33.88 | $50.12 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $33.11 Typical High $43.65 | Professional | 56 · Pre-op care only | $22.39 | $33.11 | $43.65 |
Where Missouri sits
The same service costs 8.1 times more in Texas 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· 42nd of 51
$631
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.