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 $3,162.28 Typical High $7,762.47 | Facility | None | $1,174.90 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $158.49 Typical High $1,174.90 | Professional | None | $134.90 | $158.49 | $1,174.90 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $331.13 Typical High $398.11 | Professional | None | $194.98 | $331.13 | $398.11 |
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 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $199.53 Typical High $457.09 | Professional | None | $173.78 | $199.53 | $457.09 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $446.68 Typical High $1,288.25 | Facility | None | $123.03 | $446.68 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $323.59 Typical High $1,348.96 | Professional | None | $190.55 | $323.59 | $1,348.96 |
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 $181.97 Median $245.47 Typical High $416.87 | Professional | None | $181.97 | $245.47 | $416.87 |
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 $67.61 Median $77.62 Typical High $89.13 | Professional | 52 · Reduced service | $67.61 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $31.62 Typical High $35.48 | Professional | 53 · Discontinued | $26.92 | $31.62 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $117.49 Typical High $134.90 | Professional | 54 · Surgery only | $102.33 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $23.44 Typical High $26.92 | Professional | 55 · Aftercare only | $20.42 | $23.44 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $15.85 Typical High $17.78 | Professional | 56 · Pre-op care only | $13.49 | $15.85 | $17.78 |
Where Missouri sits
The same service costs 7.2 times more in Oklahoma than in Virginia. 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· 19th of 51
$309
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.