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 $512.86 Median $660.69 Typical High $758.58 | Professional | None | $512.86 | $660.69 | $758.58 |
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 $102.33 Median $128.82 Typical High $165.96 | Professional | None | $102.33 | $128.82 | $165.96 |
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 $120.23 Median $190.55 Typical High $891.25 | Professional | None | $120.23 | $190.55 | $891.25 |
Medica Setting Facility Modifier None Typical Low $851.14 Median $3,801.89 Typical High $26,302.68 | Facility | None | $851.14 | $3,801.89 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,388.44 | Professional | None | $3,388.44 | $3,388.44 | $3,388.44 |
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 |
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 $257.04 Median $331.13 Typical High $331.13 | Professional | 52 · Reduced service | $257.04 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $131.83 Typical High $131.83 | Professional | 53 · Discontinued | $102.33 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $489.78 Typical High $489.78 | Professional | 54 · Surgery only | $389.05 | $489.78 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $97.72 Typical High $97.72 | Professional | 55 · Aftercare only | $77.62 | $97.72 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $66.07 Typical High $66.07 | Professional | 56 · Pre-op care only | $51.29 | $66.07 | $66.07 |
Where Missouri sits
The same service costs 74.1 times more in Oklahoma than in Montana. 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· 34th of 51
$851
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.