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 $1,698.24 Median $4,897.79 Typical High $7,762.47 | Facility | None | $1,698.24 | $4,897.79 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $363.08 Typical High $416.87 | Professional | None | $338.84 | $363.08 | $416.87 |
BCBS Kansas City Setting Professional Modifier None Typical Low $363.08 Median $389.05 Typical High $524.81 | Professional | None | $363.08 | $389.05 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $707.95 Median $3,630.78 Typical High $5,370.32 | Facility | None | $707.95 | $3,630.78 | $5,370.32 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Professional | None | $331.13 | $331.13 | $331.13 |
Medica Setting Facility Modifier None Typical Low $676.08 Median $4,168.69 Typical High $19,952.62 | Facility | None | $676.08 | $4,168.69 | $19,952.62 |
Medica Setting Professional Modifier None Typical Low $346.74 Median $549.54 Typical High $2,290.87 | Professional | None | $346.74 | $549.54 | $2,290.87 |
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 $331.13 Median $446.68 Typical High $831.76 | Professional | None | $331.13 | $446.68 | $831.76 |
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 $169.82 Median $181.97 Typical High $208.93 | Professional | 52 · Reduced service | $169.82 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $72.44 Typical High $83.18 | Professional | 53 · Discontinued | $67.61 | $72.44 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $275.42 Typical High $316.23 | Professional | 54 · Surgery only | $257.04 | $275.42 | $316.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $54.95 Typical High $63.10 | Professional | 55 · Aftercare only | $51.29 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $36.31 Typical High $41.69 | Professional | 56 · Pre-op care only | $33.88 | $36.31 | $41.69 |
Where Missouri sits
The same service costs 4.5 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· 31st of 51
$437
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.