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 $812.83 Median $3,162.28 Typical High $7,762.47 | Facility | None | $812.83 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $66.07 Typical High $398.11 | Professional | None | $41.69 | $66.07 | $398.11 |
Ambetter Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $66.07 Median $87.10 Typical High $117.49 | Professional | None | $66.07 | $87.10 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $67.61 Typical High $630.96 | Facility | None | $53.70 | $67.61 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $346.74 Typical High $1,288.25 | Facility | None | $102.33 | $346.74 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $95.50 Median $501.19 Typical High $758.58 | Professional | None | $95.50 | $501.19 | $758.58 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,137.96 | Facility | None | $123.03 | $602.56 | $2,137.96 |
United Setting Professional Modifier None Typical Low $60.26 Median $100.00 Typical High $169.82 | Professional | None | $60.26 | $100.00 | $169.82 |
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 $20.89 Median $30.90 Typical High $61.66 | Professional | 52 · Reduced service | $20.89 | $30.90 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $12.59 Typical High $24.55 | Professional | 53 · Discontinued | $8.32 | $12.59 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $46.77 Typical High $93.33 | Professional | 54 · Surgery only | $31.62 | $46.77 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $9.33 Typical High $18.62 | Professional | 55 · Aftercare only | $6.31 | $9.33 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $6.31 Typical High $12.30 | Professional | 56 · Pre-op care only | $4.17 | $6.31 | $12.30 |
Where Missouri sits
The same service costs 3.4 times more in Alaska than in Virginia. 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· 38th of 51
$102
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.