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 $1,148.15 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,148.15 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $79.43 Typical High $1,174.90 | Professional | None | $70.79 | $79.43 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,715.35 Typical High $7,762.47 | Facility | None | $1,412.54 | $3,715.35 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $128.82 Typical High $194.98 | Professional | None | $87.10 | $128.82 | $194.98 |
BCBS Kansas City Setting Professional Modifier None Typical Low $72.44 Median $79.43 Typical High $114.82 | Professional | None | $72.44 | $79.43 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $691.83 Typical High $2,691.53 | Facility | None | $489.78 | $691.83 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $109.65 Typical High $204.17 | Professional | None | $75.86 | $109.65 | $204.17 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,071.52 Typical High $6,918.31 | Facility | None | $54.95 | $1,071.52 | $6,918.31 |
Medica Setting Professional Modifier None Typical Low $102.33 Median $165.96 Typical High $616.60 | Professional | None | $102.33 | $165.96 | $616.60 |
United Setting Facility Modifier None Typical Low $467.74 Median $2,290.87 Typical High $10,964.78 | Facility | None | $467.74 | $2,290.87 | $10,964.78 |
United Setting Professional Modifier None Typical Low $85.11 Median $114.82 Typical High $165.96 | Professional | None | $85.11 | $114.82 | $165.96 |
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 $35.48 Median $39.81 Typical High $42.66 | Professional | 52 · Reduced service | $35.48 | $39.81 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $15.85 Typical High $16.98 | Professional | 53 · Discontinued | $14.45 | $15.85 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $58.88 Typical High $64.57 | Professional | 54 · Surgery only | $53.70 | $58.88 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $11.75 Typical High $12.88 | Professional | 55 · Aftercare only | $10.72 | $11.75 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.94 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.08 | $7.94 | $8.51 |
Where Missouri sits
The same service costs 6.5 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· 12th of 51
$166
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.