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 $1,174.90 Median $3,715.35 Typical High $7,762.47 | Facility | None | $1,174.90 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $125.89 Typical High $125.89 | Professional | None | $25.12 | $125.89 | $125.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $173.78 Median $204.17 Typical High $213.80 | Professional | None | $173.78 | $204.17 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $380.19 Typical High $426.58 | Facility | None | $194.98 | $380.19 | $426.58 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $398.11 Typical High $1,288.25 | Facility | None | $120.23 | $398.11 | $1,288.25 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $2,137.96 | Facility | None | $123.03 | $549.54 | $2,137.96 |
United Setting Professional Modifier None Typical Low $19.95 Median $29.51 Typical High $48.98 | Professional | None | $19.95 | $29.51 | $48.98 |
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 $12.59 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $12.59 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $5.01 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.05 Median $95.50 Typical High $95.50 | Professional | 54 · Surgery only | $19.05 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $3.80 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $2.51 | $12.59 | $12.59 |
Where Missouri sits
The same service costs 14.5 times more in New Hampshire than in New Jersey. 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· 4th of 51
$191
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.