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 $213.80 Median $338.84 Typical High $2,511.89 | Professional | None | $213.80 | $338.84 | $2,511.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $489.78 Median $575.44 Typical High $831.76 | Professional | None | $489.78 | $575.44 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,511.89 Typical High $3,019.95 | Facility | None | $707.95 | $2,511.89 | $3,019.95 |
Medica Setting Facility Modifier None Typical Low $851.14 Median $3,311.31 Typical High $10,964.78 | Facility | None | $851.14 | $3,311.31 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $758.58 Median $1,318.26 Typical High $3,467.37 | Professional | None | $758.58 | $1,318.26 | $3,467.37 |
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 $602.56 Median $954.99 Typical High $1,380.38 | Professional | None | $602.56 | $954.99 | $1,380.38 |
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 $158.49 Typical High $213.80 | Professional | 52 · Reduced service | $107.15 | $158.49 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $42.66 Median $64.57 Typical High $85.11 | Professional | 53 · Discontinued | $42.66 | $64.57 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $239.88 Typical High $316.23 | Professional | 54 · Surgery only | $162.18 | $239.88 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $47.86 Typical High $63.10 | Professional | 55 · Aftercare only | $32.36 | $47.86 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.38 Median $32.36 Typical High $42.66 | Professional | 56 · Pre-op care only | $21.38 | $32.36 | $42.66 |
Where Missouri sits
The same service costs 10.2 times more in Texas 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
$832
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.