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 $1,698.24 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $309.03 Typical High $407.38 | Professional | None | $204.17 | $309.03 | $407.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $331.13 Typical High $537.03 | Professional | None | $302.00 | $331.13 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $549.54 Typical High $794.33 | Facility | None | $489.78 | $549.54 | $794.33 |
Medica Setting Facility Modifier None Typical Low $457.09 Median $1,230.27 Typical High $7,943.28 | Facility | None | $457.09 | $1,230.27 | $7,943.28 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $630.96 Typical High $2,344.23 | Professional | None | $363.08 | $630.96 | $2,344.23 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,290.87 Typical High $10,964.78 | Facility | None | $467.74 | $2,290.87 | $10,964.78 |
United Setting Professional Modifier None Typical Low $346.74 Median $467.74 Typical High $691.83 | Professional | None | $346.74 | $467.74 | $691.83 |
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 $102.33 Median $151.36 Typical High $204.17 | Professional | 52 · Reduced service | $102.33 | $151.36 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $61.66 Typical High $81.28 | Professional | 53 · Discontinued | $40.74 | $61.66 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $229.09 Typical High $302.00 | Professional | 54 · Surgery only | $154.88 | $229.09 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $45.71 Typical High $60.26 | Professional | 55 · Aftercare only | $30.90 | $45.71 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $30.90 Typical High $40.74 | Professional | 56 · Pre-op care only | $20.42 | $30.90 | $40.74 |
Where Missouri sits
The same service costs 6.3 times more in Texas than in Pennsylvania. 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· 37th of 51
$398
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.