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 $933.25 Median $4,897.79 Typical High $7,762.47 | Facility | None | $933.25 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $794.33 Median $933.25 Typical High $1,202.26 | Professional | None | $794.33 | $933.25 | $1,202.26 |
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 $707.95 Median $794.33 Typical High $1,348.96 | Professional | None | $707.95 | $794.33 | $1,348.96 |
BCBS Kansas City Setting Professional Modifier None Typical Low $724.44 Median $776.25 Typical High $1,047.13 | Professional | None | $724.44 | $776.25 | $1,047.13 |
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 $724.44 Median $1,071.52 Typical High $2,238.72 | Professional | None | $724.44 | $1,071.52 | $2,238.72 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,230.27 Typical High $10,964.78 | Facility | None | $54.95 | $1,230.27 | $10,964.78 |
Medica Setting Professional Modifier None Typical Low $1,071.52 Median $1,905.46 Typical High $5,495.41 | Professional | None | $1,071.52 | $1,905.46 | $5,495.41 |
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 $870.96 Median $1,348.96 Typical High $2,290.87 | Professional | None | $870.96 | $1,348.96 | $2,290.87 |
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 $398.11 Median $467.74 Typical High $489.78 | Professional | 52 · Reduced service | $398.11 | $467.74 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $158.49 Median $186.21 Typical High $199.53 | Professional | 53 · Discontinued | $158.49 | $186.21 | $199.53 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $602.56 Median $691.83 Typical High $741.31 | Professional | 54 · Surgery only | $602.56 | $691.83 | $741.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $120.23 Median $138.04 Typical High $147.91 | Professional | 55 · Aftercare only | $120.23 | $138.04 | $147.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $79.43 Median $93.33 Typical High $97.72 | Professional | 56 · Pre-op care only | $79.43 | $93.33 | $97.72 |
Where Missouri sits
The same service costs 3.8 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· 39th of 51
$933
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.