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 $1,778.28 Median $5,623.41 Typical High $8,709.64 | Facility | None | $1,778.28 | $5,623.41 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $123.03 Typical High $275.42 | Professional | None | $102.33 | $123.03 | $275.42 |
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 $144.54 Median $194.98 Typical High $251.19 | Professional | None | $144.54 | $194.98 | $251.19 |
BCBS Kansas City Setting Professional Modifier None Typical Low $120.23 Median $134.90 Typical High $186.21 | Professional | None | $120.23 | $134.90 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $912.01 Median $2,238.72 Typical High $3,801.89 | Facility | None | $912.01 | $2,238.72 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $177.83 Typical High $295.12 | Professional | None | $128.82 | $177.83 | $295.12 |
Medica Setting Facility Modifier None Typical Low $501.19 Median $3,715.35 Typical High $26,302.68 | Facility | None | $501.19 | $3,715.35 | $26,302.68 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $245.47 Typical High $1,071.52 | Professional | None | $125.89 | $245.47 | $1,071.52 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $3,467.37 Typical High $6,918.31 | Facility | None | $1,000.00 | $3,467.37 | $6,918.31 |
United Setting Professional Modifier None Typical Low $123.03 Median $158.49 Typical High $251.19 | Professional | None | $123.03 | $158.49 | $251.19 |
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 $51.29 Median $61.66 Typical High $63.10 | Professional | 52 · Reduced service | $51.29 | $61.66 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $24.55 Typical High $25.12 | Professional | 53 · Discontinued | $20.42 | $24.55 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $91.20 Typical High $93.33 | Professional | 54 · Surgery only | $75.86 | $91.20 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $18.20 Typical High $18.62 | Professional | 55 · Aftercare only | $15.14 | $18.20 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.30 Typical High $12.59 | Professional | 56 · Pre-op care only | $10.23 | $12.30 | $12.59 |
Where Missouri sits
The same service costs 10.7 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· 19th of 51
$229
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.