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 $74,131.02 Median $83,176.38 Typical High $117,489.76 | Facility | None | $74,131.02 | $83,176.38 | $117,489.76 |
Aetna Setting Professional Modifier None Typical Low $74,131.02 Median $74,131.02 Typical High $83,176.38 | Professional | None | $74,131.02 | $74,131.02 | $83,176.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $75,857.76 Median $102,329.30 Typical High $199,526.23 | Facility | None | $75,857.76 | $102,329.30 | $199,526.23 |
Anthem BCBS Setting Professional Modifier None Typical Low $69,183.10 Median $83,176.38 Typical High $91,201.08 | Professional | None | $69,183.10 | $83,176.38 | $91,201.08 |
Cigna Setting Facility Modifier None Typical Low $87,096.36 Median $128,824.96 Typical High $144,543.98 | Facility | None | $87,096.36 | $128,824.96 | $144,543.98 |
Cigna Setting Professional Modifier None Typical Low $77,624.71 Median $77,624.71 Typical High $77,624.71 | Professional | None | $77,624.71 | $77,624.71 | $77,624.71 |
Medica Setting Facility Modifier None Typical Low $29,512.09 Median $75,857.76 Typical High $275,422.87 | Facility | None | $29,512.09 | $75,857.76 | $275,422.87 |
Medica Setting Professional Modifier None Typical Low $66,069.34 Median $66,069.34 Typical High $75,857.76 | Professional | None | $66,069.34 | $66,069.34 | $75,857.76 |
United Setting Professional Modifier None Typical Low $67,608.30 Median $75,857.76 Typical High $87,096.36 | Professional | None | $67,608.30 | $75,857.76 | $87,096.36 |
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 $36,307.81 Median $36,307.81 Typical High $41,686.94 | Professional | 52 · Reduced service | $36,307.81 | $36,307.81 | $41,686.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14,791.08 Median $14,791.08 Typical High $16,595.87 | Professional | 53 · Discontinued | $14,791.08 | $14,791.08 | $16,595.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10,964.78 Median $10,964.78 Typical High $12,589.25 | Professional | 55 · Aftercare only | $10,964.78 | $10,964.78 | $12,589.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7,413.10 Median $7,413.10 Typical High $8,317.64 | Professional | 56 · Pre-op care only | $7,413.10 | $7,413.10 | $8,317.64 |
Where Missouri sits
The same service costs 3.4 times more in Alaska than in Nebraska. 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· 29th of 51
$75,858
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.