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 $4,677.35 Median $4,677.35 Typical High $7,079.46 | Facility | None | $4,677.35 | $4,677.35 | $7,079.46 |
Aetna Setting Professional Modifier None Typical Low $4,677.35 Median $4,677.35 Typical High $4,677.35 | Professional | None | $4,677.35 | $4,677.35 | $4,677.35 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.02 Median $0.02 Typical High $0.03 | Facility | None | $0.02 | $0.02 | $0.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $4,365.16 Median $5,888.44 Typical High $5,888.44 | Professional | None | $4,365.16 | $5,888.44 | $5,888.44 |
BCBS Kansas City Setting Professional Modifier None Typical Low $5,754.40 Median $10,000.00 Typical High $10,000.00 | Professional | None | $5,754.40 | $10,000.00 | $10,000.00 |
Cigna Setting Facility Modifier None Typical Low $6,165.95 Median $11,748.98 Typical High $12,882.50 | Facility | None | $6,165.95 | $11,748.98 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $5,011.87 | Professional | None | $5,011.87 | $5,011.87 | $5,011.87 |
Medica Setting Facility Modifier None Typical Low $3,090.30 Median $8,128.31 Typical High $25,118.86 | Facility | None | $3,090.30 | $8,128.31 | $25,118.86 |
Medica Setting Professional Modifier None Typical Low $4,897.79 Median $23,988.33 Typical High $23,988.33 | Professional | None | $4,897.79 | $23,988.33 | $23,988.33 |
United Setting Professional Modifier None Typical Low $4,365.16 Median $5,128.61 Typical High $5,754.40 | Professional | None | $4,365.16 | $5,128.61 | $5,754.40 |
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 $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | 52 · Reduced service | $2,344.23 | $2,344.23 | $2,344.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $933.25 Median $933.25 Typical High $933.25 | Professional | 53 · Discontinued | $933.25 | $933.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $707.95 Median $707.95 Typical High $707.95 | Professional | 55 · Aftercare only | $707.95 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | 56 · Pre-op care only | $467.74 | $467.74 | $467.74 |
Where Missouri sits
The same service costs 1.8 times more in Alaska than in North Carolina. 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· 11th of 51
$5,129
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.