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 $181.97 Median $199.53 Typical High $446.68 | Professional | None | $181.97 | $199.53 | $446.68 |
Anthem BCBS Setting Facility Modifier None Typical Low $512.86 Median $1,230.27 Typical High $2,511.89 | Facility | None | $512.86 | $1,230.27 | $2,511.89 |
Anthem BCBS Setting Professional Modifier None Typical Low $208.93 Median $251.19 Typical High $416.87 | Professional | None | $208.93 | $251.19 | $416.87 |
BCBS Kansas City Setting Professional Modifier None Typical Low $186.21 Median $199.53 Typical High $288.40 | Professional | None | $186.21 | $199.53 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $4,365.16 Typical High $6,760.83 | Facility | None | $851.14 | $4,365.16 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $281.84 Typical High $489.78 | Professional | None | $194.98 | $281.84 | $489.78 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $2,089.30 Typical High $18,197.01 | Facility | None | $54.95 | $2,089.30 | $18,197.01 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $407.38 Typical High $1,479.11 | Professional | None | $263.03 | $407.38 | $1,479.11 |
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 $223.87 Median $302.00 Typical High $426.58 | Professional | None | $223.87 | $302.00 | $426.58 |
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 $91.20 Median $100.00 Typical High $109.65 | Professional | 52 · Reduced service | $91.20 | $100.00 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $39.81 Typical High $43.65 | Professional | 53 · Discontinued | $36.31 | $39.81 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $147.91 Typical High $162.18 | Professional | 54 · Surgery only | $134.90 | $147.91 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $29.51 Typical High $32.36 | Professional | 55 · Aftercare only | $27.54 | $29.51 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.95 Typical High $21.88 | Professional | 56 · Pre-op care only | $18.20 | $19.95 | $21.88 |
Where Missouri sits
The same service costs 6.9 times more in Tennessee 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· 34th 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.