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 $501.19 Median $758.58 Typical High $1,000.00 | Professional | None | $501.19 | $758.58 | $1,000.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,348.96 | Facility | None | $1,258.93 | $1,258.93 | $1,348.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $758.58 | Professional | None | $562.34 | $660.69 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,981.07 Typical High $5,754.40 | Facility | None | $707.95 | $3,981.07 | $5,754.40 |
Medica Setting Facility Modifier None Typical Low $1,023.29 Median $3,801.89 Typical High $21,877.62 | Facility | None | $1,023.29 | $3,801.89 | $21,877.62 |
Medica Setting Professional Modifier None Typical Low $588.84 Median $1,023.29 Typical High $5,754.40 | Professional | None | $588.84 | $1,023.29 | $5,754.40 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,981.07 | $8,709.64 |
United Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $1,202.26 | Professional | None | $588.84 | $758.58 | $1,202.26 |
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 $251.19 Median $380.19 Typical High $501.19 | Professional | 52 · Reduced service | $251.19 | $380.19 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $151.36 Typical High $199.53 | Professional | 53 · Discontinued | $102.33 | $151.36 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $562.34 Typical High $741.31 | Professional | 54 · Surgery only | $380.19 | $562.34 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $112.20 Typical High $151.36 | Professional | 55 · Aftercare only | $75.86 | $112.20 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $75.86 Typical High $100.00 | Professional | 56 · Pre-op care only | $50.12 | $75.86 | $100.00 |
Where Missouri sits
The same service costs 5.1 times more in Texas than in Delaware. 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· 44th of 51
$832
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.