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 $134.90 Median $162.18 Typical High $1,174.90 | Professional | None | $134.90 | $162.18 | $1,174.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,318.26 Median $3,467.37 Typical High $7,079.46 | Facility | None | $1,318.26 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $194.98 Median $239.88 Typical High $302.00 | Professional | None | $194.98 | $239.88 | $302.00 |
BCBS Kansas City Setting Professional Modifier None Typical Low $162.18 Median $177.83 Typical High $251.19 | Professional | None | $162.18 | $177.83 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $213.80 Typical High $309.03 | Facility | None | $162.18 | $213.80 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $229.09 Typical High $407.38 | Professional | None | $169.82 | $229.09 | $407.38 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $338.84 Typical High $1,288.25 | Facility | None | $54.95 | $338.84 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $331.13 Typical High $1,258.93 | Professional | None | $169.82 | $331.13 | $1,258.93 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,137.96 | Facility | None | $123.03 | $602.56 | $2,137.96 |
United Setting Professional Modifier None Typical Low $165.96 Median $213.80 Typical High $331.13 | Professional | None | $165.96 | $213.80 | $331.13 |
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 $67.61 Median $81.28 Typical High $83.18 | Professional | 52 · Reduced service | $67.61 | $81.28 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $32.36 Typical High $33.11 | Professional | 53 · Discontinued | $26.92 | $32.36 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $123.03 Typical High $125.89 | Professional | 54 · Surgery only | $102.33 | $123.03 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $24.55 Typical High $25.12 | Professional | 55 · Aftercare only | $20.42 | $24.55 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $16.22 Typical High $16.60 | Professional | 56 · Pre-op care only | $13.49 | $16.22 | $16.60 |
Where Missouri sits
The same service costs 3.2 times more in Alaska than in Texas. 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
$245
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.