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 $2,511.89 Median $5,370.32 Typical High $8,317.64 | Facility | None | $2,511.89 | $5,370.32 | $8,317.64 |
Aetna Setting Professional Modifier None Typical Low $275.42 Median $436.52 Typical High $4,570.88 | Professional | None | $275.42 | $436.52 | $4,570.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,709.64 Median $10,232.93 Typical High $12,882.50 | Facility | None | $8,709.64 | $10,232.93 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $891.25 | Professional | None | $501.19 | $602.56 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $741.31 Median $16,218.10 Typical High $28,183.83 | Facility | None | $741.31 | $16,218.10 | $28,183.83 |
Medica Setting Facility Modifier None Typical Low $1,122.02 Median $5,248.07 Typical High $81,283.05 | Facility | None | $1,122.02 | $5,248.07 | $81,283.05 |
Medica Setting Professional Modifier None Typical Low $794.33 Median $1,380.38 Typical High $2,951.21 | Professional | None | $794.33 | $1,380.38 | $2,951.21 |
United Setting Facility Modifier None Typical Low $1,174.90 Median $5,248.07 Typical High $19,054.61 | Facility | None | $1,174.90 | $5,248.07 | $19,054.61 |
United Setting Professional Modifier None Typical Low $645.65 Median $1,023.29 Typical High $1,698.24 | Professional | None | $645.65 | $1,023.29 | $1,698.24 |
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 $138.04 Median $204.17 Typical High $269.15 | Professional | 52 · Reduced service | $138.04 | $204.17 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $81.28 Typical High $109.65 | Professional | 53 · Discontinued | $54.95 | $81.28 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $309.03 Typical High $407.38 | Professional | 54 · Surgery only | $204.17 | $309.03 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $61.66 Typical High $81.28 | Professional | 55 · Aftercare only | $41.69 | $61.66 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $40.74 Typical High $53.70 | Professional | 56 · Pre-op care only | $27.54 | $40.74 | $53.70 |
Where Missouri sits
The same service costs 27.5 times more in Oklahoma than in New York. 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· 41st of 51
$933
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.