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 $489,778.82 Median $524,807.46 Typical High $831,763.77 | Facility | None | $489,778.82 | $524,807.46 | $831,763.77 |
Aetna Setting Professional Modifier None Typical Low $512,861.38 Median $524,807.46 Typical High $616,595.00 | Professional | None | $512,861.38 | $524,807.46 | $616,595.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.02 Median $0.03 Typical High $0.04 | Facility | None | $0.02 | $0.03 | $0.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $501,187.23 Median $602,559.59 Typical High $602,559.59 | Professional | None | $501,187.23 | $602,559.59 | $602,559.59 |
BCBS Kansas City Setting Professional Modifier None Typical Low $562,341.33 Median $562,341.33 Typical High $1,023,292.99 | Professional | None | $562,341.33 | $562,341.33 | $1,023,292.99 |
Cigna Setting Professional Modifier None Typical Low $478,630.09 Median $478,630.09 Typical High $602,559.59 | Professional | None | $478,630.09 | $478,630.09 | $602,559.59 |
Medica Setting Facility Modifier None Typical Low $478,630.09 Median $645,654.23 Typical High $891,250.94 | Facility | None | $478,630.09 | $645,654.23 | $891,250.94 |
Medica Setting Professional Modifier None Typical Low $1,000,000.00 Median $1,000,000.00 Typical High $1,000,000.00 | Professional | None | $1,000,000.00 | $1,000,000.00 | $1,000,000.00 |
United Setting Facility Modifier None Typical Low $512,861.38 Median $512,861.38 Typical High $512,861.38 | Facility | None | $512,861.38 | $512,861.38 | $512,861.38 |
United Setting Professional Modifier None Typical Low $489,778.82 Median $489,778.82 Typical High $588,843.66 | Professional | None | $489,778.82 | $489,778.82 | $588,843.66 |
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 $257,039.58 Median $263,026.80 Typical High $309,029.54 | Professional | 52 · Reduced service | $257,039.58 | $263,026.80 | $309,029.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102,329.30 Median $104,712.85 Typical High $123,026.88 | Professional | 53 · Discontinued | $102,329.30 | $104,712.85 | $123,026.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75,857.76 Median $79,432.82 Typical High $91,201.08 | Professional | 55 · Aftercare only | $75,857.76 | $79,432.82 | $91,201.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51,286.14 Median $52,480.75 Typical High $61,659.50 | Professional | 56 · Pre-op care only | $51,286.14 | $52,480.75 | $61,659.50 |
Where Missouri sits
The same service costs 2.0 times more in Texas than in New Jersey. 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· 9th of 51
$602,560
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.