How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $8,511.38 Median $10,471.29 Typical High $12,589.25 | Facility | None | $8,511.38 | $10,471.29 | $12,589.25 |
Aetna Setting Professional Modifier None Typical Low $8,511.38 Median $8,511.38 Typical High $10,471.29 | Professional | None | $8,511.38 | $8,511.38 | $10,471.29 |
Anthem BCBS Setting Facility Modifier None Typical Low $8,709.64 Median $11,748.98 Typical High $22,908.68 | Facility | None | $8,709.64 | $11,748.98 | $22,908.68 |
Anthem BCBS Setting Professional Modifier None Typical Low $7,943.28 Median $10,471.29 Typical High $10,471.29 | Professional | None | $7,943.28 | $10,471.29 | $10,471.29 |
BCBS Kansas City Setting Professional Modifier None Typical Low $10,232.93 Median $17,782.79 Typical High $17,782.79 | Professional | None | $10,232.93 | $17,782.79 | $17,782.79 |
Cigna Setting Facility Modifier None Typical Low $11,220.18 Median $21,379.62 Typical High $22,908.68 | Facility | None | $11,220.18 | $21,379.62 | $22,908.68 |
Cigna Setting Professional Modifier None Typical Low $8,912.51 Median $8,912.51 Typical High $8,912.51 | Professional | None | $8,912.51 | $8,912.51 | $8,912.51 |
Medica Setting Facility Modifier None Typical Low $8,128.31 Median $9,549.93 Typical High $36,307.81 | Facility | None | $8,128.31 | $9,549.93 | $36,307.81 |
Medica Setting Professional Modifier None Typical Low $8,511.38 Median $37,153.52 Typical High $37,153.52 | Professional | None | $8,511.38 | $37,153.52 | $37,153.52 |
United Setting Professional Modifier None Typical Low $7,943.28 Median $9,332.54 Typical High $10,232.93 | Professional | None | $7,943.28 | $9,332.54 | $10,232.93 |
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 $4,265.80 Median $4,265.80 Typical High $5,248.07 | Professional | 52 · Reduced service | $4,265.80 | $4,265.80 | $5,248.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,698.24 Median $1,698.24 Typical High $2,089.30 | Professional | 53 · Discontinued | $1,698.24 | $1,698.24 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,258.93 Median $1,258.93 Typical High $1,584.89 | Professional | 55 · Aftercare only | $1,258.93 | $1,258.93 | $1,584.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $851.14 Median $851.14 Typical High $1,047.13 | Professional | 56 · Pre-op care only | $851.14 | $851.14 | $1,047.13 |
Where Missouri sits
The same service costs 26.3 times more in Alaska than in Montana. 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
$8,913
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.