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 $1,548.82 Median $4,570.88 Typical High $7,762.47 | Facility | None | $1,548.82 | $4,570.88 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $2,089.30 | Professional | None | $64.57 | $64.57 | $2,089.30 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,621.81 Median $1,862.09 Typical High $1,949.84 | Professional | None | $1,621.81 | $1,862.09 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $2,454.71 Median $2,754.23 Typical High $2,951.21 | Professional | 50 · Both sides | $2,454.71 | $2,754.23 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $2,137.96 Typical High $2,691.53 | Facility | None | $575.44 | $2,137.96 | $2,691.53 |
Medica Setting Facility Modifier None Typical Low $1,023.29 Median $4,365.16 Typical High $12,882.50 | Facility | None | $1,023.29 | $4,365.16 | $12,882.50 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,570.88 Typical High $12,302.69 | Facility | None | $977.24 | $4,570.88 | $12,302.69 |
United Setting Professional Modifier None Typical Low $891.25 Median $1,258.93 Typical High $1,949.84 | Professional | None | $891.25 | $1,258.93 | $1,949.84 |
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 $32.36 Median $32.36 Typical High $602.56 | Professional | 52 · Reduced service | $32.36 | $32.36 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $239.88 | Professional | 53 · Discontinued | $12.88 | $12.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $48.98 Typical High $912.01 | Professional | 54 · Surgery only | $48.98 | $48.98 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $181.97 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $60.26 | $120.23 | $120.23 |
Where Missouri sits
The same service costs 51.3 times more in Oklahoma 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· 18th of 51
$1,738
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.