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 $245.47 Median $323.59 Typical High $489.78 | Professional | None | $245.47 | $323.59 | $489.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $794.33 | Professional | None | $645.65 | $707.95 | $794.33 |
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 $1,000.00 Median $3,801.89 Typical High $13,803.84 | Facility | None | $1,000.00 | $3,801.89 | $13,803.84 |
Medica Setting Professional Modifier None Typical Low $588.84 Median $1,023.29 Typical High $2,818.38 | Professional | None | $588.84 | $1,023.29 | $2,818.38 |
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 $316.23 Median $724.44 Typical High $1,148.15 | Professional | None | $316.23 | $724.44 | $1,148.15 |
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 $123.03 Median $158.49 Typical High $245.47 | Professional | 52 · Reduced service | $123.03 | $158.49 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $64.57 Typical High $97.72 | Professional | 53 · Discontinued | $48.98 | $64.57 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $239.88 Typical High $363.08 | Professional | 54 · Surgery only | $186.21 | $239.88 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $47.86 Typical High $72.44 | Professional | 55 · Aftercare only | $37.15 | $47.86 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $32.36 Typical High $48.98 | Professional | 56 · Pre-op care only | $24.55 | $32.36 | $48.98 |
Where Missouri sits
The same service costs 7.8 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· 21st of 51
$955
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.