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 $74.13 Median $75.86 Typical High $102.33 | Facility | None | $74.13 | $75.86 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $107.15 | Professional | None | $75.86 | $75.86 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $102.33 Typical High $199.53 | Facility | None | $75.86 | $102.33 | $199.53 |
Anthem BCBS Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $100.00 | Professional | None | $85.11 | $100.00 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $154.88 Typical High $177.83 | Facility | None | $107.15 | $154.88 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $95.50 Typical High $316.23 | Facility | None | $70.79 | $95.50 | $316.23 |
Medica Setting Professional Modifier None Typical Low $83.18 Median $97.72 Typical High $102.33 | Professional | None | $83.18 | $97.72 | $102.33 |
United Setting Professional Modifier None Typical Low $85.11 Median $95.50 Typical High $102.33 | Professional | None | $85.11 | $95.50 | $102.33 |
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 $38.02 Median $38.02 Typical High $45.71 | Professional | 52 · Reduced service | $38.02 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $18.20 | Professional | 53 · Discontinued | $15.14 | $15.14 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $13.49 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $9.12 |
Where Missouri sits
The same service costs 2.9 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· 7th 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.