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 $1,174.90 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,174.90 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $239.88 Typical High $1,174.90 | Professional | None | $131.83 | $239.88 | $1,174.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $144.54 Typical High $204.17 | Professional | None | $109.65 | $144.54 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $1,905.46 Typical High $2,691.53 | Facility | None | $707.95 | $1,905.46 | $2,691.53 |
Medica Setting Facility Modifier None Typical Low $1,000.00 Median $3,801.89 Typical High $8,511.38 | Facility | None | $1,000.00 | $3,801.89 | $8,511.38 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $295.12 Typical High $1,513.56 | Professional | None | $199.53 | $295.12 | $1,513.56 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $7,943.28 | Facility | None | $1,258.93 | $3,981.07 | $7,943.28 |
United Setting Professional Modifier None Typical Low $181.97 Median $245.47 Typical High $416.87 | Professional | None | $181.97 | $245.47 | $416.87 |
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 $66.07 Median $120.23 Typical High $128.82 | Professional | 52 · Reduced service | $66.07 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $47.86 Typical High $51.29 | Professional | 53 · Discontinued | $26.30 | $47.86 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $177.83 Typical High $194.98 | Professional | 54 · Surgery only | $97.72 | $177.83 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $35.48 Typical High $38.90 | Professional | 55 · Aftercare only | $19.50 | $35.48 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $23.99 Typical High $25.70 | Professional | 56 · Pre-op care only | $13.18 | $23.99 | $25.70 |
Where Missouri sits
The same service costs 19.5 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· 50th of 51
$178
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.