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 $1,778.28 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,778.28 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $891.25 Median $1,513.56 Typical High $2,511.89 | Professional | None | $891.25 | $1,513.56 | $2,511.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $186.21 Median $1,318.26 Typical High $2,238.72 | Professional | None | $186.21 | $1,318.26 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,570.40 Typical High $3,162.28 | Facility | None | $707.95 | $2,570.40 | $3,162.28 |
Medica Setting Facility Modifier None Typical Low $1,071.52 Median $3,388.44 Typical High $12,022.64 | Facility | None | $1,071.52 | $3,388.44 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $2,511.89 Median $4,466.84 Typical High $10,232.93 | Professional | None | $2,511.89 | $4,466.84 | $10,232.93 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,467.37 | $6,918.31 |
United Setting Professional Modifier None Typical Low $1,995.26 Median $3,311.31 Typical High $5,495.41 | Professional | None | $1,995.26 | $3,311.31 | $5,495.41 |
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 $446.68 Median $758.58 Typical High $870.96 | Professional | 52 · Reduced service | $446.68 | $758.58 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $177.83 Median $309.03 Typical High $354.81 | Professional | 53 · Discontinued | $177.83 | $309.03 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $660.69 Median $1,148.15 Typical High $1,318.26 | Professional | 54 · Surgery only | $660.69 | $1,148.15 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $229.09 Typical High $263.03 | Professional | 55 · Aftercare only | $134.90 | $229.09 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $89.13 Median $151.36 Typical High $173.78 | Professional | 56 · Pre-op care only | $89.13 | $151.36 | $173.78 |
Where Missouri sits
The same service costs 15.8 times more in Wisconsin than in Nebraska. 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
$1,950
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.