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 $6,309.57 Typical High $13,489.63 | Facility | None | $2,511.89 | $6,309.57 | $13,489.63 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,698.24 Typical High $4,570.88 | Professional | None | $1,071.52 | $1,698.24 | $4,570.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $13,803.84 Median $31,622.78 Typical High $63,095.73 | Facility | None | $13,803.84 | $31,622.78 | $63,095.73 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,380.38 Median $1,513.56 Typical High $2,570.40 | Professional | None | $1,380.38 | $1,513.56 | $2,570.40 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,691.53 | Facility | None | $489.78 | $691.83 | $2,691.53 |
Medica Setting Facility Modifier None Typical Low $524.81 Median $1,698.24 Typical High $11,220.18 | Facility | None | $524.81 | $1,698.24 | $11,220.18 |
Medica Setting Professional Modifier None Typical Low $2,630.27 Median $4,677.35 Typical High $12,302.69 | Professional | None | $2,630.27 | $4,677.35 | $12,302.69 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,290.87 Typical High $10,964.78 | Facility | None | $467.74 | $2,290.87 | $10,964.78 |
United Setting Professional Modifier None Typical Low $2,089.30 Median $3,388.44 Typical High $5,754.40 | Professional | None | $2,089.30 | $3,388.44 | $5,754.40 |
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 $537.03 Median $741.31 Typical High $1,047.13 | Professional | 52 · Reduced service | $537.03 | $741.31 | $1,047.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $295.12 Typical High $416.87 | Professional | 53 · Discontinued | $213.80 | $295.12 | $416.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $1,096.48 Typical High $1,584.89 | Professional | 54 · Surgery only | $794.33 | $1,096.48 | $1,584.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $218.78 Typical High $316.23 | Professional | 55 · Aftercare only | $158.49 | $218.78 | $316.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $147.91 Typical High $208.93 | Professional | 56 · Pre-op care only | $107.15 | $147.91 | $208.93 |
Where Missouri sits
The same service costs 5.8 times more in California than in Arkansas. 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· 39th of 51
$2,089
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.