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 $52.48 Median $52.48 Typical High $102.33 | Facility | None | $52.48 | $52.48 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $61.66 Typical High $97.72 | Professional | None | $52.48 | $61.66 | $97.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $74.13 Median $87.10 Typical High $144.54 | Professional | None | $74.13 | $87.10 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $2,344.23 Median $3,981.07 Typical High $4,466.84 | Facility | None | $2,344.23 | $3,981.07 | $4,466.84 |
Medica Setting Facility Modifier None Typical Low $4,365.16 Median $5,128.61 Typical High $10,471.29 | Facility | None | $4,365.16 | $5,128.61 | $10,471.29 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $138.04 | Professional | None | $128.82 | $128.82 | $138.04 |
United Setting Facility Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $5,128.61 | Facility | None | $4,897.79 | $4,897.79 | $5,128.61 |
United Setting Professional Modifier None Typical Low $83.18 Median $91.20 Typical High $147.91 | Professional | None | $83.18 | $91.20 | $147.91 |
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 $26.30 Median $30.90 Typical High $47.86 | Professional | 52 · Reduced service | $26.30 | $30.90 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $12.59 Typical High $19.50 | Professional | 53 · Discontinued | $10.47 | $12.59 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $9.33 Typical High $14.45 | Professional | 55 · Aftercare only | $7.76 | $9.33 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $6.17 Typical High $9.77 | Professional | 56 · Pre-op care only | $5.25 | $6.17 | $9.77 |
Where Missouri sits
The same service costs 3.2 times more in Alaska than in New York. 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· 28th of 51
$87.10
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.