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 $3,388.44 Median $3,388.44 Typical High $5,011.87 | Facility | None | $3,388.44 | $3,388.44 | $5,011.87 |
Aetna Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $3,467.37 | Professional | None | $3,388.44 | $3,388.44 | $3,467.37 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,698.24 Median $4,073.80 Typical High $9,120.11 | Facility | None | $1,698.24 | $4,073.80 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $3,162.28 Median $4,168.69 Typical High $4,168.69 | Professional | None | $3,162.28 | $4,168.69 | $4,168.69 |
BCBS Kansas City Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $7,079.46 | Professional | None | $5,128.61 | $5,128.61 | $7,079.46 |
Cigna Setting Facility Modifier None Typical Low $4,073.80 Median $5,888.44 Typical High $6,606.93 | Facility | None | $4,073.80 | $5,888.44 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
Medica Setting Facility Modifier None Typical Low $1,288.25 Median $4,073.80 Typical High $15,135.61 | Facility | None | $1,288.25 | $4,073.80 | $15,135.61 |
Medica Setting Professional Modifier None Typical Low $3,388.44 Median $4,265.80 Typical High $15,488.17 | Professional | None | $3,388.44 | $4,265.80 | $15,488.17 |
United Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
United Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $4,073.80 | Professional | None | $3,467.37 | $3,467.37 | $4,073.80 |
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 $1,698.24 Median $1,698.24 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,698.24 | $1,698.24 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $676.08 Typical High $691.83 | Professional | 53 · Discontinued | $676.08 | $676.08 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $501.19 Typical High $524.81 | Professional | 55 · Aftercare only | $501.19 | $501.19 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $338.84 Typical High $346.74 | Professional | 56 · Pre-op care only | $338.84 | $338.84 | $346.74 |
Where Missouri sits
The same service costs 1.6 times more in North Carolina 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· 24th of 51
$3,548
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.