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 $1,148.15 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,148.15 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $87.10 Typical High $1,174.90 | Professional | None | $75.86 | $87.10 | $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 $75.86 Median $100.00 Typical High $151.36 | Professional | None | $75.86 | $100.00 | $151.36 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $114.82 Median $147.91 Typical High $223.87 | Professional | 50 · Both sides | $114.82 | $147.91 | $223.87 |
BCBS Kansas City Setting Professional Modifier None Typical Low $67.61 Median $75.86 Typical High $104.71 | Professional | None | $67.61 | $75.86 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $1,479.11 Typical High $1,819.70 | Facility | None | $446.68 | $1,479.11 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $102.33 Typical High $186.21 | Professional | None | $74.13 | $102.33 | $186.21 |
Medica Setting Facility Modifier None Typical Low $338.84 Median $1,584.89 Typical High $12,022.64 | Facility | None | $338.84 | $1,584.89 | $12,022.64 |
Medica Setting Professional Modifier None Typical Low $83.18 Median $190.55 Typical High $1,659.59 | Professional | None | $83.18 | $190.55 | $1,659.59 |
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 $75.86 Median $104.71 Typical High $208.93 | Professional | None | $75.86 | $104.71 | $208.93 |
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 $38.02 Median $42.66 Typical High $46.77 | Professional | 52 · Reduced service | $38.02 | $42.66 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $16.98 Typical High $18.62 | Professional | 53 · Discontinued | $15.14 | $16.98 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $64.57 Typical High $69.18 | Professional | 54 · Surgery only | $56.23 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $12.88 Typical High $14.13 | Professional | 55 · Aftercare only | $11.22 | $12.88 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.51 Typical High $9.33 | Professional | 56 · Pre-op care only | $7.59 | $8.51 | $9.33 |
Where Missouri sits
The same service costs 11.2 times more in Tennessee 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· 31st of 51
$115
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.