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 $851.14 Median $3,162.28 Typical High $7,762.47 | Facility | None | $851.14 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $645.65 Typical High $1,174.90 | Professional | None | $512.86 | $645.65 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $446.68 Median $1,621.81 Typical High $3,890.45 | Facility | None | $446.68 | $1,621.81 | $3,890.45 |
Anthem BCBS Setting Professional Modifier None Typical Low $575.44 Median $831.76 Typical High $1,122.02 | Professional | None | $575.44 | $831.76 | $1,122.02 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,230.27 Typical High $1,698.24 | Professional | 50 · Both sides | $870.96 | $1,230.27 | $1,698.24 |
BCBS Kansas City Setting Professional Modifier None Typical Low $501.19 Median $549.54 Typical High $776.25 | Professional | None | $501.19 | $549.54 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $4,897.79 Typical High $7,244.36 | Facility | None | $707.95 | $4,897.79 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $645.65 Typical High $1,288.25 | Professional | None | $562.34 | $645.65 | $1,288.25 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $1,380.38 Typical High $26,915.35 | Facility | None | $54.95 | $1,380.38 | $26,915.35 |
Medica Setting Professional Modifier None Typical Low $691.83 Median $1,288.25 Typical High $4,168.69 | Professional | None | $691.83 | $1,288.25 | $4,168.69 |
United Setting Facility Modifier None Typical Low $562.34 Median $1,513.56 Typical High $3,235.94 | Facility | None | $562.34 | $1,513.56 | $3,235.94 |
United Setting Professional Modifier None Typical Low $588.84 Median $870.96 Typical High $1,479.11 | Professional | None | $588.84 | $870.96 | $1,479.11 |
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 $257.04 Median $323.59 Typical High $323.59 | Professional | 52 · Reduced service | $257.04 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $128.82 Typical High $131.83 | Professional | 53 · Discontinued | $102.33 | $128.82 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $478.63 Typical High $489.78 | Professional | 54 · Surgery only | $380.19 | $478.63 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $95.50 Typical High $97.72 | Professional | 55 · Aftercare only | $75.86 | $95.50 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $64.57 Typical High $66.07 | Professional | 56 · Pre-op care only | $51.29 | $64.57 | $66.07 |
Where Missouri sits
The same service costs 3.9 times more in Alaska 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· 18th of 51
$955
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.