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 $54.95 Median $54.95 Typical High $109.65 | Facility | None | $54.95 | $54.95 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $87.10 Typical High $109.65 | Professional | None | $54.95 | $87.10 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $87.10 Median $95.50 Typical High $158.49 | Professional | None | $87.10 | $95.50 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $851.14 Typical High $954.99 | Facility | None | $512.86 | $851.14 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Medica Setting Facility Modifier None Typical Low $83.18 Median $426.58 Typical High $1,047.13 | Facility | None | $83.18 | $426.58 | $1,047.13 |
Medica Setting Professional Modifier None Typical Low $85.11 Median $177.83 Typical High $524.81 | Professional | None | $85.11 | $177.83 | $524.81 |
United Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,148.15 | Facility | None | $1,071.52 | $1,071.52 | $1,148.15 |
United Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $177.83 | Professional | None | $83.18 | $97.72 | $177.83 |
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 $27.54 Median $43.65 Typical High $54.95 | Professional | 52 · Reduced service | $27.54 | $43.65 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $17.38 Typical High $21.88 | Professional | 53 · Discontinued | $10.96 | $17.38 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $13.18 Typical High $16.22 | Professional | 55 · Aftercare only | $8.32 | $13.18 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $8.71 Typical High $10.96 | Professional | 56 · Pre-op care only | $5.50 | $8.71 | $10.96 |
Where Missouri sits
The same service costs 5.0 times more in Alaska than in Pennsylvania. 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· 27th of 51
$97.72
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.