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 $1,778.28 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,778.28 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $218.78 | Professional | None | $112.20 | $147.91 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $346.74 Typical High $478.63 | Professional | None | $213.80 | $346.74 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,137.96 Typical High $2,691.53 | Facility | None | $575.44 | $2,137.96 | $2,691.53 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $416.87 Typical High $1,288.25 | Facility | None | $123.03 | $416.87 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $562.34 Typical High $1,318.26 | Professional | None | $269.15 | $562.34 | $1,318.26 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $2,137.96 | Facility | None | $123.03 | $549.54 | $2,137.96 |
United Setting Professional Modifier None Typical Low $223.87 Median $426.58 Typical High $602.56 | Professional | None | $223.87 | $426.58 | $602.56 |
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 $56.23 Median $74.13 Typical High $109.65 | Professional | 52 · Reduced service | $56.23 | $74.13 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $29.51 Typical High $43.65 | Professional | 53 · Discontinued | $22.39 | $29.51 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $112.20 Typical High $165.96 | Professional | 54 · Surgery only | $83.18 | $112.20 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $22.39 Typical High $33.11 | Professional | 55 · Aftercare only | $16.60 | $22.39 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $14.79 Typical High $21.88 | Professional | 56 · Pre-op care only | $11.22 | $14.79 | $21.88 |
Where Missouri sits
The same service costs 18.6 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· 8th of 51
$407
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.