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 $257.04 Median $407.38 Typical High $3,467.37 | Professional | None | $257.04 | $407.38 | $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 $446.68 Median $489.78 Typical High $758.58 | Professional | None | $446.68 | $489.78 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $7,413.10 Typical High $11,220.18 | Facility | None | $707.95 | $7,413.10 | $11,220.18 |
Medica Setting Facility Modifier None Typical Low $1,000.00 Median $5,248.07 Typical High $23,442.29 | Facility | None | $1,000.00 | $5,248.07 | $23,442.29 |
Medica Setting Professional Modifier None Typical Low $436.52 Median $741.31 Typical High $3,162.28 | Professional | None | $436.52 | $741.31 | $3,162.28 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $5,623.41 Typical High $19,054.61 | Facility | None | $1,174.90 | $5,623.41 | $19,054.61 |
United Setting Professional Modifier None Typical Low $389.05 Median $537.03 Typical High $1,479.11 | Professional | None | $389.05 | $537.03 | $1,479.11 |
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 $128.82 Median $204.17 Typical High $251.19 | Professional | 52 · Reduced service | $128.82 | $204.17 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $83.18 Typical High $100.00 | Professional | 53 · Discontinued | $51.29 | $83.18 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $309.03 Typical High $380.19 | Professional | 54 · Surgery only | $190.55 | $309.03 | $380.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $61.66 Typical High $75.86 | Professional | 55 · Aftercare only | $38.02 | $61.66 | $75.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $40.74 Typical High $50.12 | Professional | 56 · Pre-op care only | $25.70 | $40.74 | $50.12 |
Where Missouri sits
The same service costs 16.2 times more in Arkansas than in West Virginia. 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
$617
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.