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 $69.18 Median $102.33 Typical High $102.33 | Facility | None | $69.18 | $102.33 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $102.33 | Professional | None | $87.10 | $87.10 | $102.33 |
Anthem BCBS Setting Facility Modifier None Typical Low $85.11 Median $114.82 Typical High $223.87 | Facility | None | $85.11 | $114.82 | $223.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $158.49 Typical High $177.83 | Facility | None | $102.33 | $158.49 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Medica Setting Facility Modifier None Typical Low $61.66 Median $144.54 Typical High $371.54 | Facility | None | $61.66 | $144.54 | $371.54 |
Medica Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $131.83 | Professional | None | $83.18 | $97.72 | $131.83 |
United Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $128.82 | Professional | None | $85.11 | $100.00 | $128.82 |
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 $43.65 Median $43.65 Typical High $51.29 | Professional | 52 · Reduced service | $43.65 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $20.42 | Professional | 53 · Discontinued | $17.38 | $17.38 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $15.49 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $10.23 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $10.23 |
Where Missouri sits
The same service costs 1.7 times more in Texas than in Arkansas. 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· 19th of 51
$100
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.