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 $89.13 Median $4,677.35 Typical High $7,762.47 | Facility | None | $89.13 | $4,677.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $89.13 Typical High $128.82 | Professional | None | $56.23 | $89.13 | $128.82 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,709.64 Median $10,232.93 Typical High $12,882.50 | Facility | None | $8,709.64 | $10,232.93 | $12,882.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $85.11 Typical High $151.36 | Professional | None | $61.66 | $85.11 | $151.36 |
BCBS Kansas City Setting Professional Modifier None Typical Low $46.77 Median $85.11 Typical High $114.82 | Professional | None | $46.77 | $85.11 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $2,691.53 Typical High $2,691.53 | Facility | None | $1,096.48 | $2,691.53 | $2,691.53 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $87.10 Typical High $177.83 | Professional | None | $51.29 | $87.10 | $177.83 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $234.42 Typical High $1,258.93 | Facility | None | $54.95 | $234.42 | $1,258.93 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $398.11 Typical High $1,023.29 | Professional | None | $128.82 | $398.11 | $1,023.29 |
United Setting Facility Modifier None Typical Low $123.03 Median $549.54 Typical High $2,137.96 | Facility | None | $123.03 | $549.54 | $2,137.96 |
United Setting Professional Modifier None Typical Low $75.86 Median $128.82 Typical High $234.42 | Professional | None | $75.86 | $128.82 | $234.42 |
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 $27.54 Median $44.67 Typical High $54.95 | Professional | 52 · Reduced service | $27.54 | $44.67 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $17.78 Typical High $21.88 | Professional | 53 · Discontinued | $11.22 | $17.78 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $67.61 Typical High $81.28 | Professional | 54 · Surgery only | $41.69 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $13.49 Typical High $16.60 | Professional | 55 · Aftercare only | $8.32 | $13.49 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $8.91 Typical High $10.96 | Professional | 56 · Pre-op care only | $5.62 | $8.91 | $10.96 |
Where Missouri sits
The same service costs 3.7 times more in Wisconsin than in Florida. 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· 31st of 51
$102
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.