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 $213.80 Median $346.74 Typical High $3,467.37 | Professional | None | $213.80 | $346.74 | $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 $354.81 Median $389.05 Typical High $602.56 | Professional | None | $354.81 | $389.05 | $602.56 |
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 $41,686.94 | Facility | None | $1,000.00 | $5,248.07 | $41,686.94 |
Medica Setting Professional Modifier None Typical Low $446.68 Median $758.58 Typical High $2,691.53 | Professional | None | $446.68 | $758.58 | $2,691.53 |
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 $371.54 Median $562.34 Typical High $1,202.26 | Professional | None | $371.54 | $562.34 | $1,202.26 |
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 $107.15 Median $173.78 Typical High $213.80 | Professional | 52 · Reduced service | $107.15 | $173.78 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $69.18 Typical High $85.11 | Professional | 53 · Discontinued | $42.66 | $69.18 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $257.04 Typical High $316.23 | Professional | 54 · Surgery only | $162.18 | $257.04 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $51.29 Typical High $63.10 | Professional | 55 · Aftercare only | $32.36 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $34.67 Typical High $42.66 | Professional | 56 · Pre-op care only | $21.38 | $34.67 | $42.66 |
Where Missouri sits
The same service costs 15.8 times more in Arkansas 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· 42nd of 51
$562
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.