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 $758.58 Median $1,202.26 Typical High $4,570.88 | Professional | None | $758.58 | $1,202.26 | $4,570.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $6,918.31 Median $15,848.93 Typical High $31,622.78 | Facility | None | $6,918.31 | $15,848.93 | $31,622.78 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $741.31 Typical High $2,691.53 | Facility | None | $489.78 | $741.31 | $2,691.53 |
Medica Setting Facility Modifier None Typical Low $467.74 Median $1,318.26 Typical High $7,943.28 | Facility | None | $467.74 | $1,318.26 | $7,943.28 |
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 $1,412.54 Median $2,137.96 Typical High $3,715.35 | Professional | None | $1,412.54 | $2,137.96 | $3,715.35 |
4 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 $380.19 Median $588.84 Typical High $741.31 | Professional | 52 · Reduced service | $380.19 | $588.84 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $151.36 Median $234.42 Typical High $295.12 | Professional | 53 · Discontinued | $151.36 | $234.42 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $112.20 Median $173.78 Typical High $223.87 | Professional | 55 · Aftercare only | $112.20 | $173.78 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $75.86 Median $117.49 Typical High $147.91 | Professional | 56 · Pre-op care only | $75.86 | $117.49 | $147.91 |
Where Missouri sits
The same service costs 9.8 times more in Wisconsin than in North Carolina. 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· 10th of 51
$2,138
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.