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 $323.59 Median $407.38 Typical High $1,174.90 | Professional | None | $323.59 | $407.38 | $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 $363.08 Median $478.63 Typical High $676.08 | Professional | None | $363.08 | $478.63 | $676.08 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $549.54 Median $724.44 Typical High $1,000.00 | Professional | 50 · Both sides | $549.54 | $724.44 | $1,000.00 |
BCBS Kansas City Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $489.78 | Professional | None | $316.23 | $354.81 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $2,691.53 Typical High $3,890.45 | Facility | None | $446.68 | $2,691.53 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $812.83 | Professional | None | $354.81 | $457.09 | $812.83 |
Medica Setting Facility Modifier None Typical Low $676.08 Median $2,754.23 Typical High $14,454.40 | Facility | None | $676.08 | $2,754.23 | $14,454.40 |
Medica Setting Professional Modifier None Typical Low $436.52 Median $812.83 Typical High $2,630.27 | Professional | None | $436.52 | $812.83 | $2,630.27 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $2,818.38 Typical High $5,495.41 | Facility | None | $1,000.00 | $2,818.38 | $5,495.41 |
United Setting Professional Modifier None Typical Low $371.54 Median $549.54 Typical High $933.25 | Professional | None | $371.54 | $549.54 | $933.25 |
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 $162.18 Median $204.17 Typical High $208.93 | Professional | 52 · Reduced service | $162.18 | $204.17 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $81.28 Typical High $83.18 | Professional | 53 · Discontinued | $64.57 | $81.28 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $302.00 Typical High $309.03 | Professional | 54 · Surgery only | $239.88 | $302.00 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $60.26 Typical High $61.66 | Professional | 55 · Aftercare only | $48.98 | $60.26 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $40.74 Typical High $41.69 | Professional | 56 · Pre-op care only | $32.36 | $40.74 | $41.69 |
Where Missouri sits
The same service costs 7.8 times more in Oklahoma 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· 27th of 51
$562
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.