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 $5,623.41 Typical High $11,748.98 | Facility | None | $2,511.89 | $5,623.41 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $398.11 Typical High $3,388.44 | Professional | None | $251.19 | $398.11 | $3,388.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,047.13 Typical High $1,621.81 | Professional | None | $851.14 | $1,047.13 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $20,417.38 Typical High $30,199.52 | Facility | None | $707.95 | $20,417.38 | $30,199.52 |
Medica Setting Facility Modifier None Typical Low $1,348.96 Median $8,511.38 Typical High $107,151.93 | Facility | None | $1,348.96 | $8,511.38 | $107,151.93 |
Medica Setting Professional Modifier None Typical Low $1,230.27 Median $2,238.72 Typical High $3,715.35 | Professional | None | $1,230.27 | $2,238.72 | $3,715.35 |
United Setting Facility Modifier None Typical Low $1,548.82 Median $8,709.64 Typical High $40,738.03 | Facility | None | $1,548.82 | $8,709.64 | $40,738.03 |
United Setting Professional Modifier None Typical Low $851.14 Median $1,584.89 Typical High $2,398.83 | Professional | None | $851.14 | $1,584.89 | $2,398.83 |
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 $125.89 Median $173.78 Typical High $245.47 | Professional | 52 · Reduced service | $125.89 | $173.78 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $69.18 Typical High $97.72 | Professional | 53 · Discontinued | $50.12 | $69.18 | $97.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $263.03 Typical High $371.54 | Professional | 54 · Surgery only | $186.21 | $263.03 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $52.48 Typical High $74.13 | Professional | 55 · Aftercare only | $37.15 | $52.48 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $34.67 Typical High $48.98 | Professional | 56 · Pre-op care only | $25.12 | $34.67 | $48.98 |
Where Missouri sits
The same service costs 50.1 times more in Arkansas 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· 30th of 51
$1,514
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.