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 $2,290.87 Median $5,623.41 Typical High $13,182.57 | Facility | None | $2,290.87 | $5,623.41 | $13,182.57 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $489.78 Typical High $3,467.37 | Professional | None | $309.03 | $489.78 | $3,467.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,309.57 Median $9,332.54 Typical High $13,803.84 | Facility | None | $6,309.57 | $9,332.54 | $13,803.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $794.33 | Professional | None | $478.63 | $524.81 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $18,620.87 Typical High $28,183.83 | Facility | None | $707.95 | $18,620.87 | $28,183.83 |
Medica Setting Facility Modifier None Typical Low $1,258.93 Median $8,511.38 Typical High $87,096.36 | Facility | None | $1,258.93 | $8,511.38 | $87,096.36 |
Medica Setting Professional Modifier None Typical Low $676.08 Median $1,174.90 Typical High $3,801.89 | Professional | None | $676.08 | $1,174.90 | $3,801.89 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $9,549.93 Typical High $38,018.94 | Facility | None | $1,548.82 | $9,549.93 | $38,018.94 |
United Setting Professional Modifier None Typical Low $562.34 Median $851.14 Typical High $1,584.89 | Professional | None | $562.34 | $851.14 | $1,584.89 |
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 $151.36 Median $245.47 Typical High $302.00 | Professional | 52 · Reduced service | $151.36 | $245.47 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $97.72 Typical High $120.23 | Professional | 53 · Discontinued | $61.66 | $97.72 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $371.54 Typical High $457.09 | Professional | 54 · Surgery only | $229.09 | $371.54 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $74.13 Typical High $91.20 | Professional | 55 · Aftercare only | $45.71 | $74.13 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $48.98 Typical High $60.26 | Professional | 56 · Pre-op care only | $30.90 | $48.98 | $60.26 |
Where Missouri sits
The same service costs 29.5 times more in Louisiana than in Maine. 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· 43rd of 51
$794
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.