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 $275.42 Median $4,897.79 Typical High $7,762.47 | Facility | None | $275.42 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $275.42 Typical High $380.19 | Professional | None | $239.88 | $275.42 | $380.19 |
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 $269.15 Median $363.08 Typical High $446.68 | Professional | None | $269.15 | $363.08 | $446.68 |
BCBS Kansas City Setting Professional Modifier None Typical Low $223.87 Median $239.88 Typical High $316.23 | Professional | None | $223.87 | $239.88 | $316.23 |
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 $218.78 Median $302.00 Typical High $676.08 | Professional | None | $218.78 | $302.00 | $676.08 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,122.02 Typical High $7,585.78 | Facility | None | $54.95 | $1,122.02 | $7,585.78 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $562.34 Typical High $1,659.59 | Professional | None | $323.59 | $562.34 | $1,659.59 |
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 $263.03 Median $407.38 Typical High $691.83 | Professional | None | $263.03 | $407.38 | $691.83 |
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 $120.23 Median $138.04 Typical High $147.91 | Professional | 52 · Reduced service | $120.23 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $56.23 Typical High $60.26 | Professional | 53 · Discontinued | $47.86 | $56.23 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $208.93 Typical High $223.87 | Professional | 54 · Surgery only | $181.97 | $208.93 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $41.69 Typical High $44.67 | Professional | 55 · Aftercare only | $36.31 | $41.69 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $27.54 Typical High $29.51 | Professional | 56 · Pre-op care only | $23.99 | $27.54 | $29.51 |
Where Missouri sits
The same service costs 4.0 times more in Wisconsin 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· 30th of 51
$372
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.