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 $41.69 Median $47.86 Typical High $56.23 | Facility | None | $41.69 | $47.86 | $56.23 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $63.10 | Professional | None | $41.69 | $41.69 | $63.10 |
Ambetter Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $38.02 | Professional | None | $32.36 | $32.36 | $38.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $39.81 Median $53.70 Typical High $104.71 | Facility | None | $39.81 | $53.70 | $104.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $74.13 Typical High $83.18 | Facility | None | $47.86 | $74.13 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
Medica Setting Facility Modifier None Typical Low $38.90 Median $52.48 Typical High $169.82 | Facility | None | $38.90 | $52.48 | $169.82 |
Medica Setting Professional Modifier None Typical Low $38.90 Median $43.65 Typical High $46.77 | Professional | None | $38.90 | $43.65 | $46.77 |
United Setting Professional Modifier None Typical Low $39.81 Median $44.67 Typical High $47.86 | Professional | None | $39.81 | $44.67 | $47.86 |
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 $20.89 Median $20.89 Typical High $23.99 | Professional | 52 · Reduced service | $20.89 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $9.55 | Professional | 53 · Discontinued | $8.32 | $8.32 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $7.24 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $4.79 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $4.79 |
Where Missouri sits
The same service costs 1.5 times more in Arizona than in Rhode Island. 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· 9th of 51
$45.71
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.