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 $1,412.54 Median $3,715.35 Typical High $7,762.47 | Facility | None | $1,412.54 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $1,412.54 Typical High $1,659.59 | Professional | None | $100.00 | $1,412.54 | $1,659.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $104.71 Median $251.19 Typical High $2,398.83 | Professional | None | $104.71 | $251.19 | $2,398.83 |
BCBS Kansas City Setting Professional Modifier None Typical Low $81.28 Median $1,288.25 Typical High $1,659.59 | Professional | None | $81.28 | $1,288.25 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $2,691.53 Typical High $3,467.37 | Facility | None | $707.95 | $2,691.53 | $3,467.37 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $239.88 Typical High $2,884.03 | Professional | None | $93.33 | $239.88 | $2,884.03 |
Medica Setting Facility Modifier None Typical Low $870.96 Median $2,884.03 Typical High $11,481.54 | Facility | None | $870.96 | $2,884.03 | $11,481.54 |
Medica Setting Professional Modifier None Typical Low $1,949.84 Median $4,897.79 Typical High $9,772.37 | Professional | None | $1,949.84 | $4,897.79 | $9,772.37 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $3,981.07 Typical High $8,709.64 | Facility | None | $1,258.93 | $3,981.07 | $8,709.64 |
United Setting Professional Modifier None Typical Low $138.04 Median $1,174.90 Typical High $4,073.80 | Professional | None | $138.04 | $1,174.90 | $4,073.80 |
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 $50.12 Median $83.18 Typical High $812.83 | Professional | 52 · Reduced service | $50.12 | $83.18 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $33.11 Typical High $331.13 | Professional | 53 · Discontinued | $19.95 | $33.11 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $125.89 Typical High $1,230.27 | Professional | 54 · Surgery only | $75.86 | $125.89 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $25.12 Typical High $245.47 | Professional | 55 · Aftercare only | $15.14 | $25.12 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $16.60 Typical High $165.96 | Professional | 56 · Pre-op care only | $10.00 | $16.60 | $165.96 |
Where Missouri sits
The same service costs 19.1 times more in Alaska than in Nebraska. 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· 32nd of 51
$1,413
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.