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 $93.33 Median $4,897.79 Typical High $7,762.47 | Facility | None | $93.33 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $67.61 Typical High $81.28 | Professional | None | $57.54 | $67.61 | $81.28 |
Anthem BCBS Setting Facility Modifier None Typical Low $151.36 Median $1,621.81 Typical High $3,890.45 | Facility | None | $151.36 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $70.79 Typical High $112.20 | Professional | None | $50.12 | $70.79 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $416.87 Typical High $602.56 | Facility | None | $58.88 | $416.87 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $79.43 Typical High $134.90 | Professional | None | $69.18 | $79.43 | $134.90 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $281.84 Typical High $1,862.09 | Facility | None | $54.95 | $281.84 | $1,862.09 |
Medica Setting Professional Modifier None Typical Low $66.07 Median $138.04 Typical High $575.44 | Professional | None | $66.07 | $138.04 | $575.44 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,454.71 | Facility | None | $123.03 | $602.56 | $2,454.71 |
United Setting Professional Modifier None Typical Low $63.10 Median $91.20 Typical High $147.91 | Professional | None | $63.10 | $91.20 | $147.91 |
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 $28.84 Median $33.88 Typical High $38.02 | Professional | 52 · Reduced service | $28.84 | $33.88 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $13.80 Typical High $15.14 | Professional | 53 · Discontinued | $11.48 | $13.80 | $15.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $51.29 Typical High $56.23 | Professional | 54 · Surgery only | $43.65 | $51.29 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $10.23 Typical High $11.22 | Professional | 55 · Aftercare only | $8.71 | $10.23 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.92 Typical High $7.59 | Professional | 56 · Pre-op care only | $5.75 | $6.92 | $7.59 |
Where Missouri sits
The same service costs 5.5 times more in Arkansas than in Kentucky. 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· 36th of 51
$91.20
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.