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 $2,511.89 Median $5,623.41 Typical High $11,748.98 | Facility | None | $2,511.89 | $5,623.41 | $11,748.98 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $2,511.89 | Professional | None | $575.44 | $575.44 | $2,511.89 |
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 $575.44 Median $676.08 Typical High $1,174.90 | Professional | None | $575.44 | $676.08 | $1,174.90 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $870.96 Median $1,023.29 Typical High $1,737.80 | Professional | 50 · Both sides | $870.96 | $1,023.29 | $1,737.80 |
BCBS Kansas City Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $870.96 | Professional | None | $562.34 | $630.96 | $870.96 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $10,232.93 Typical High $14,791.08 | Facility | None | $707.95 | $10,232.93 | $14,791.08 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $1,445.44 | Professional | None | $602.56 | $758.58 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $3,548.13 Typical High $40,738.03 | Facility | None | $54.95 | $3,548.13 | $40,738.03 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $1,148.15 Typical High $4,786.30 | Professional | None | $645.65 | $1,148.15 | $4,786.30 |
United Setting Facility Modifier None Typical Low $977.24 Median $4,570.88 Typical High $13,489.63 | Facility | None | $977.24 | $4,570.88 | $13,489.63 |
United Setting Professional Modifier None Typical Low $602.56 Median $870.96 Typical High $1,445.44 | Professional | None | $602.56 | $870.96 | $1,445.44 |
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 $281.84 Median $288.40 Typical High $346.74 | Professional | 52 · Reduced service | $281.84 | $288.40 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $138.04 | Professional | 53 · Discontinued | $114.82 | $114.82 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $426.58 Typical High $524.81 | Professional | 54 · Surgery only | $426.58 | $426.58 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $85.11 Typical High $104.71 | Professional | 55 · Aftercare only | $85.11 | $85.11 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $69.18 | Professional | 56 · Pre-op care only | $57.54 | $57.54 | $69.18 |
Where Missouri sits
The same service costs 11.7 times more in Oklahoma than in Utah. 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· 33rd of 51
$851
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.