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 $50.12 Median $57.54 Typical High $1,698.24 | Professional | None | $50.12 | $57.54 | $1,698.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $50.12 Median $72.44 Typical High $102.33 | Professional | None | $50.12 | $72.44 | $102.33 |
BCBS Kansas City Setting Professional Modifier None Typical Low $46.77 Median $51.29 Typical High $67.61 | Professional | None | $46.77 | $51.29 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $66.07 | Facility | None | $50.12 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $45.71 Median $67.61 Typical High $117.49 | Professional | None | $45.71 | $67.61 | $117.49 |
Medica Setting Facility Modifier None Typical Low $100.00 Median $380.19 Typical High $1,288.25 | Facility | None | $100.00 | $380.19 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $67.61 Median $128.82 Typical High $512.86 | Professional | None | $67.61 | $128.82 | $512.86 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $2,137.96 | Facility | None | $123.03 | $537.03 | $2,137.96 |
United Setting Professional Modifier None Typical Low $54.95 Median $83.18 Typical High $144.54 | Professional | None | $54.95 | $83.18 | $144.54 |
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 $25.12 Median $28.84 Typical High $30.90 | Professional | 52 · Reduced service | $25.12 | $28.84 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $11.48 Typical High $12.30 | Professional | 53 · Discontinued | $10.00 | $11.48 | $12.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $43.65 Typical High $45.71 | Professional | 54 · Surgery only | $37.15 | $43.65 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $8.71 Typical High $9.12 | Professional | 55 · Aftercare only | $7.41 | $8.71 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.75 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.01 | $5.75 | $6.17 |
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· 24th of 51
$85.11
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.