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 $190.55 Median $309.03 Typical High $707.95 | Professional | None | $190.55 | $309.03 | $707.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $186.21 Median $218.78 Typical High $275.42 | Professional | None | $186.21 | $218.78 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $562.34 Typical High $1,659.59 | Facility | None | $398.11 | $562.34 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $446.68 | Professional | None | $288.40 | $288.40 | $446.68 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $1,096.48 Typical High $2,089.30 | Facility | None | $380.19 | $1,096.48 | $2,089.30 |
Medica Setting Professional Modifier None Typical Low $147.91 Median $467.74 Typical High $2,041.74 | Professional | None | $147.91 | $467.74 | $2,041.74 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $2,344.23 | Facility | None | $398.11 | $1,148.15 | $2,344.23 |
United Setting Professional Modifier None Typical Low $147.91 Median $331.13 Typical High $501.19 | Professional | None | $147.91 | $331.13 | $501.19 |
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 $95.50 Median $147.91 Typical High $186.21 | Professional | 52 · Reduced service | $95.50 | $147.91 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $60.26 Typical High $74.13 | Professional | 53 · Discontinued | $38.02 | $60.26 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $223.87 Typical High $281.84 | Professional | 54 · Surgery only | $141.25 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $44.67 Typical High $56.23 | Professional | 55 · Aftercare only | $28.18 | $44.67 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $29.51 Typical High $37.15 | Professional | 56 · Pre-op care only | $19.05 | $29.51 | $37.15 |
Where Missouri sits
The same service costs 8.3 times more in Oklahoma than in Rhode Island. 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· 45th of 51
$309
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.