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 $41.69 Median $47.86 Typical High $1,698.24 | Professional | None | $41.69 | $47.86 | $1,698.24 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $46.77 Typical High $81.28 | Professional | None | $40.74 | $46.77 | $81.28 |
BCBS Kansas City Setting Professional Modifier None Typical Low $33.88 Median $36.31 Typical High $48.98 | Professional | None | $33.88 | $36.31 | $48.98 |
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 $37.15 Median $54.95 Typical High $97.72 | Professional | None | $37.15 | $54.95 | $97.72 |
Medica Setting Facility Modifier None Typical Low $75.86 Median $407.38 Typical High $1,288.25 | Facility | None | $75.86 | $407.38 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $54.95 Median $107.15 Typical High $912.01 | Professional | None | $54.95 | $107.15 | $912.01 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,137.96 | Facility | None | $123.03 | $602.56 | $2,137.96 |
United Setting Professional Modifier None Typical Low $44.67 Median $69.18 Typical High $120.23 | Professional | None | $44.67 | $69.18 | $120.23 |
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 $20.89 Median $23.99 Typical High $25.12 | Professional | 52 · Reduced service | $20.89 | $23.99 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $9.55 Typical High $10.23 | Professional | 53 · Discontinued | $8.32 | $9.55 | $10.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $36.31 Typical High $38.02 | Professional | 54 · Surgery only | $30.90 | $36.31 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $7.24 Typical High $7.59 | Professional | 55 · Aftercare only | $6.17 | $7.24 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.79 Typical High $5.13 | Professional | 56 · Pre-op care only | $4.17 | $4.79 | $5.13 |
Where Missouri sits
The same service costs 9.3 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· 35th of 51
$60.26
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.