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 $1,071.52 Median $4,677.35 Typical High $23,988.33 | Facility | None | $1,071.52 | $4,677.35 | $23,988.33 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $302.00 Typical High $588.84 | Professional | None | $218.78 | $302.00 | $588.84 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,412.54 Median $3,801.89 Typical High $13,489.63 | Facility | None | $1,412.54 | $3,801.89 | $13,489.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $302.00 Median $446.68 Typical High $691.83 | Professional | None | $302.00 | $446.68 | $691.83 |
Anthem BCBS Setting Professional Modifier 62 · Two surgeons Typical Low $190.55 Median $281.84 Typical High $446.68 | Professional | 62 · Two surgeons | $190.55 | $281.84 | $446.68 |
BCBS Kansas City Setting Professional Modifier None Typical Low $251.19 Median $398.11 Typical High $537.03 | Professional | None | $251.19 | $398.11 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,290.87 Typical High $3,311.31 | Facility | None | $645.65 | $2,290.87 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $398.11 Typical High $758.58 | Professional | None | $275.42 | $398.11 | $758.58 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $1,202.26 Typical High $16,218.10 | Facility | None | $398.11 | $1,202.26 | $16,218.10 |
Medica Setting Professional Modifier None Typical Low $416.87 Median $954.99 Typical High $4,897.79 | Professional | None | $416.87 | $954.99 | $4,897.79 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $16,982.44 | Facility | None | $398.11 | $1,148.15 | $16,982.44 |
United Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $794.33 | Professional | None | $302.00 | $457.09 | $794.33 |
6 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 $109.65 Median $151.36 Typical High $194.98 | Professional | 52 · Reduced service | $109.65 | $151.36 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $60.26 Typical High $79.43 | Professional | 53 · Discontinued | $43.65 | $60.26 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $229.09 Typical High $295.12 | Professional | 54 · Surgery only | $162.18 | $229.09 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $45.71 Typical High $58.88 | Professional | 55 · Aftercare only | $32.36 | $45.71 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $30.20 Typical High $38.90 | Professional | 56 · Pre-op care only | $21.88 | $30.20 | $38.90 |
Ambetter Setting Professional Modifier 52 · Reduced service Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | 52 · Reduced service | $89.13 | $89.13 | $89.13 |
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· 25th of 51
$490
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.