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 $151.36 Median $239.88 Typical High $3,467.37 | Professional | None | $151.36 | $239.88 | $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 $208.93 Median $229.09 Typical High $346.74 | Professional | None | $208.93 | $229.09 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,570.40 Typical High $3,090.30 | Facility | None | $707.95 | $2,570.40 | $3,090.30 |
Medica Setting Facility Modifier None Typical Low $676.08 Median $3,019.95 Typical High $10,232.93 | Facility | None | $676.08 | $3,019.95 | $10,232.93 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $549.54 Typical High $1,819.70 | Professional | None | $316.23 | $549.54 | $1,819.70 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,548.13 Typical High $8,317.64 | Facility | None | $1,000.00 | $3,548.13 | $8,317.64 |
United Setting Professional Modifier None Typical Low $263.03 Median $398.11 Typical High $707.95 | Professional | None | $263.03 | $398.11 | $707.95 |
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 $75.86 Median $117.49 Typical High $147.91 | Professional | 52 · Reduced service | $75.86 | $117.49 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $46.77 Typical High $58.88 | Professional | 53 · Discontinued | $30.20 | $46.77 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $177.83 Typical High $223.87 | Professional | 54 · Surgery only | $112.20 | $177.83 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $35.48 Typical High $44.67 | Professional | 55 · Aftercare only | $22.39 | $35.48 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $23.44 Typical High $29.51 | Professional | 56 · Pre-op care only | $15.14 | $23.44 | $29.51 |
Where Missouri sits
The same service costs 10.7 times more in Colorado 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· 44th of 51
$372
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.