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 $229.09 Median $269.15 Typical High $269.15 | Facility | None | $229.09 | $269.15 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $269.15 | Professional | None | $229.09 | $229.09 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $223.87 Median $302.00 Typical High $588.84 | Facility | None | $223.87 | $302.00 | $588.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $269.15 Median $416.87 Typical High $467.74 | Facility | None | $269.15 | $416.87 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
Medica Setting Facility Modifier None Typical Low $208.93 Median $234.42 Typical High $851.14 | Facility | None | $208.93 | $234.42 | $851.14 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $251.19 | Professional | None | $208.93 | $245.47 | $251.19 |
United Setting Professional Modifier None Typical Low $223.87 Median $257.04 Typical High $275.42 | Professional | None | $223.87 | $257.04 | $275.42 |
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 $114.82 Median $114.82 Typical High $134.90 | Professional | 52 · Reduced service | $114.82 | $114.82 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $53.70 | Professional | 53 · Discontinued | $45.71 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $40.74 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $26.92 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $26.92 |
Where Missouri sits
The same service costs 2.0 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· 14th of 51
$251
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.