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 $162.18 Median $194.98 Typical High $218.78 | Facility | None | $162.18 | $194.98 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $194.98 Typical High $218.78 | Professional | None | $190.55 | $194.98 | $218.78 |
Anthem BCBS Setting Facility Modifier None Typical Low $190.55 Median $257.04 Typical High $501.19 | Facility | None | $190.55 | $257.04 | $501.19 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $501.19 Typical High $549.54 | Facility | None | $263.03 | $501.19 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Professional | None | $213.80 | $213.80 | $213.80 |
Medica Setting Facility Modifier None Typical Low $147.91 Median $194.98 Typical High $660.69 | Facility | None | $147.91 | $194.98 | $660.69 |
Medica Setting Professional Modifier None Typical Low $162.18 Median $190.55 Typical High $213.80 | Professional | None | $162.18 | $190.55 | $213.80 |
United Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
United Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $229.09 | Professional | None | $190.55 | $213.80 | $229.09 |
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 $95.50 Median $95.50 Typical High $109.65 | Professional | 52 · Reduced service | $95.50 | $95.50 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.90 Typical High $43.65 | Professional | 53 · Discontinued | $38.02 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $33.11 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.50 Typical High $21.88 | Professional | 56 · Pre-op care only | $19.05 | $19.50 | $21.88 |
Where Missouri sits
The same service costs 1.9 times more in Arizona than in Alabama. 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· 18th of 51
$214
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.