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 $512.86 Median $512.86 Typical High $616.60 | Facility | None | $512.86 | $512.86 | $616.60 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $512.86 Typical High $616.60 | Professional | None | $489.78 | $512.86 | $616.60 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $691.83 | Professional | None | $398.11 | $467.74 | $691.83 |
BCBS Kansas City Setting Professional Modifier None Typical Low $537.03 Median $575.44 Typical High $812.83 | Professional | None | $537.03 | $575.44 | $812.83 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $489.78 Typical High $851.14 | Professional | None | $457.09 | $489.78 | $851.14 |
Medica Setting Facility Modifier None Typical Low $524.81 Median $758.58 Typical High $2,238.72 | Facility | None | $524.81 | $758.58 | $2,238.72 |
Medica Setting Professional Modifier None Typical Low $407.38 Median $3,162.28 Typical High $3,630.78 | Professional | None | $407.38 | $3,162.28 | $3,630.78 |
United Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $707.95 | Professional | None | $407.38 | $446.68 | $707.95 |
4 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 $245.47 Median $257.04 Typical High $302.00 | Professional | 52 · Reduced service | $245.47 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $104.71 Typical High $123.03 | Professional | 53 · Discontinued | $97.72 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $77.62 Typical High $91.20 | Professional | 55 · Aftercare only | $74.13 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $51.29 Typical High $61.66 | Professional | 56 · Pre-op care only | $48.98 | $51.29 | $61.66 |
Where Missouri sits
The same service costs 3.2 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· 38th of 51
$501
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.