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 $32.36 Median $38.02 Typical High $38.02 | Facility | None | $32.36 | $38.02 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $48.98 | Professional | None | $32.36 | $32.36 | $48.98 |
Ambetter Setting Professional Modifier None Typical Low $25.70 Median $26.92 Typical High $30.20 | Professional | None | $25.70 | $26.92 | $30.20 |
Anthem BCBS Setting Facility Modifier None Typical Low $31.62 Median $42.66 Typical High $83.18 | Facility | None | $31.62 | $42.66 | $83.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $38.02 Median $57.54 Typical High $66.07 | Facility | None | $38.02 | $57.54 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
Medica Setting Facility Modifier None Typical Low $31.62 Median $41.69 Typical High $131.83 | Facility | None | $31.62 | $41.69 | $131.83 |
Medica Setting Professional Modifier None Typical Low $30.90 Median $36.31 Typical High $37.15 | Professional | None | $30.90 | $36.31 | $37.15 |
United Setting Professional Modifier None Typical Low $30.90 Median $34.67 Typical High $38.02 | Professional | None | $30.90 | $34.67 | $38.02 |
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 $16.22 Median $16.22 Typical High $18.62 | Professional | 52 · Reduced service | $16.22 | $16.22 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $7.59 | Professional | 53 · Discontinued | $6.46 | $6.46 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $5.62 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.80 |
Where Missouri sits
The same service costs 97.7 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· 13th of 51
$36.31
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.