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 $512.86 Median $776.25 Typical High $3,467.37 | Professional | None | $512.86 | $776.25 | $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 $363.08 Median $398.11 Typical High $831.76 | Professional | None | $363.08 | $398.11 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $5,128.61 Typical High $7,762.47 | Facility | None | $707.95 | $5,128.61 | $7,762.47 |
Medica Setting Facility Modifier None Typical Low $776.25 Median $3,090.30 Typical High $13,182.57 | Facility | None | $776.25 | $3,090.30 | $13,182.57 |
Medica Setting Professional Modifier None Typical Low $467.74 Median $812.83 Typical High $5,370.32 | Professional | None | $467.74 | $812.83 | $5,370.32 |
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 $426.58 Median $588.84 Typical High $2,454.71 | Professional | None | $426.58 | $588.84 | $2,454.71 |
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 $257.04 Median $389.05 Typical High $501.19 | Professional | 52 · Reduced service | $257.04 | $389.05 | $501.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $154.88 Typical High $199.53 | Professional | 53 · Discontinued | $102.33 | $154.88 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $588.84 Typical High $758.58 | Professional | 54 · Surgery only | $380.19 | $588.84 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $117.49 Typical High $151.36 | Professional | 55 · Aftercare only | $75.86 | $117.49 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $77.62 Typical High $100.00 | Professional | 56 · Pre-op care only | $51.29 | $77.62 | $100.00 |
Where Missouri sits
The same service costs 14.8 times more in Texas 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· 35th of 51
$741
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.