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 $1,698.24 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,096.48 Typical High $1,380.38 | Professional | None | $933.25 | $1,096.48 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,949.84 | Professional | None | $1,023.29 | $1,202.26 | $1,949.84 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,513.56 Median $1,819.70 Typical High $2,884.03 | Professional | 50 · Both sides | $1,513.56 | $1,819.70 | $2,884.03 |
BCBS Kansas City Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,318.26 | Professional | None | $1,023.29 | $1,023.29 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,398.83 Typical High $2,818.38 | Facility | None | $645.65 | $2,398.83 | $2,818.38 |
Cigna Setting Professional Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $2,187.76 | Professional | None | $1,047.13 | $1,318.26 | $2,187.76 |
Medica Setting Facility Modifier None Typical Low $1,071.52 Median $3,801.89 Typical High $26,302.68 | Facility | None | $1,071.52 | $3,801.89 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $1,071.52 Median $2,344.23 Typical High $10,715.19 | Professional | None | $1,071.52 | $2,344.23 | $10,715.19 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,467.37 | $6,918.31 |
United Setting Professional Modifier None Typical Low $1,047.13 Median $1,513.56 Typical High $2,454.71 | Professional | None | $1,047.13 | $1,513.56 | $2,454.71 |
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 $467.74 Median $549.54 Typical High $602.56 | Professional | 52 · Reduced service | $467.74 | $549.54 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $218.78 Typical High $245.47 | Professional | 53 · Discontinued | $186.21 | $218.78 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $812.83 Typical High $912.01 | Professional | 54 · Surgery only | $691.83 | $812.83 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $165.96 Typical High $181.97 | Professional | 55 · Aftercare only | $138.04 | $165.96 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $109.65 Typical High $120.23 | Professional | 56 · Pre-op care only | $93.33 | $109.65 | $120.23 |
Where Missouri sits
The same service costs 4.8 times more in Alaska 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· 38th of 51
$1,349
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.