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 $1,174.90 Median $4,466.84 Typical High $7,762.47 | Facility | None | $1,174.90 | $4,466.84 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $141.25 Typical High $1,698.24 | Professional | None | $123.03 | $141.25 | $1,698.24 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,981.07 | Facility | None | $446.68 | $1,621.81 | $3,981.07 |
Anthem BCBS Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $263.03 | Professional | None | $120.23 | $181.97 | $263.03 |
BCBS Setting Professional Modifier None Typical Low $104.71 Median $109.65 Typical High $158.49 | Professional | None | $104.71 | $109.65 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,041.74 Typical High $2,951.21 | Facility | None | $446.68 | $2,041.74 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $162.18 Typical High $288.40 | Professional | None | $109.65 | $162.18 | $288.40 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $3,715.35 Typical High $12,022.64 | Facility | None | $398.11 | $3,715.35 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $158.49 Median $309.03 Typical High $1,698.24 | Professional | None | $158.49 | $309.03 | $1,698.24 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,760.83 | Facility | None | $1,000.00 | $3,467.37 | $6,760.83 |
United Setting Professional Modifier None Typical Low $128.82 Median $204.17 Typical High $354.81 | Professional | None | $128.82 | $204.17 | $354.81 |
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 $60.26 Median $70.79 Typical High $75.86 | Professional | 52 · Reduced service | $60.26 | $70.79 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $28.18 Typical High $30.20 | Professional | 53 · Discontinued | $24.55 | $28.18 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $104.71 Typical High $112.20 | Professional | 54 · Surgery only | $91.20 | $104.71 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $20.89 Typical High $22.39 | Professional | 55 · Aftercare only | $18.20 | $20.89 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $14.13 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.30 | $14.13 | $15.14 |
Where Missouri sits
The same service costs 12.9 times more in Arkansas 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· 20th of 51
$263
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.