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 $891.25 Median $3,715.35 Typical High $7,762.47 | Facility | None | $891.25 | $3,715.35 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $741.31 Typical High $933.25 | Professional | None | $190.55 | $741.31 | $933.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,238.72 Median $3,981.07 Typical High $7,762.47 | Facility | None | $2,238.72 | $3,981.07 | $7,762.47 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $691.83 Typical High $1,174.90 | Professional | None | $213.80 | $691.83 | $1,174.90 |
BCBS Kansas City Setting Professional Modifier None Typical Low $190.55 Median $758.58 Typical High $1,047.13 | Professional | None | $190.55 | $758.58 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $575.44 Typical High $1,380.38 | Professional | None | $204.17 | $575.44 | $1,380.38 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,202.26 Typical High $6,606.93 | Facility | None | $54.95 | $1,202.26 | $6,606.93 |
Medica Setting Professional Modifier None Typical Low $1,071.52 Median $3,090.30 Typical High $6,165.95 | Professional | None | $1,071.52 | $3,090.30 | $6,165.95 |
United Setting Facility Modifier None Typical Low $1,862.09 Median $3,981.07 Typical High $8,317.64 | Facility | None | $1,862.09 | $3,981.07 | $8,317.64 |
United Setting Professional Modifier None Typical Low $257.04 Median $776.25 Typical High $1,995.26 | Professional | None | $257.04 | $776.25 | $1,995.26 |
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 $95.50 Median $302.00 Typical High $446.68 | Professional | 52 · Reduced service | $95.50 | $302.00 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $120.23 Typical High $177.83 | Professional | 53 · Discontinued | $38.02 | $120.23 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $446.68 Typical High $676.08 | Professional | 54 · Surgery only | $144.54 | $446.68 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $89.13 Typical High $134.90 | Professional | 55 · Aftercare only | $28.84 | $89.13 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $60.26 Typical High $89.13 | Professional | 56 · Pre-op care only | $19.05 | $60.26 | $89.13 |
Where Missouri sits
The same service costs 5.4 times more in Wisconsin than in Maryland. 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
$851
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.