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 $338.84 Median $398.11 Typical High $457.09 | Facility | None | $338.84 | $398.11 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $616.60 | Professional | None | $338.84 | $338.84 | $616.60 |
Ambetter Setting Professional Modifier None Typical Low $208.93 Median $269.15 Typical High $316.23 | Professional | None | $208.93 | $269.15 | $316.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $331.13 Median $446.68 Typical High $870.96 | Facility | None | $331.13 | $446.68 | $870.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $602.56 Typical High $691.83 | Facility | None | $398.11 | $602.56 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $371.54 | Professional | None | $371.54 | $371.54 | $371.54 |
Medica Setting Facility Modifier None Typical Low $316.23 Median $363.08 Typical High $1,288.25 | Facility | None | $316.23 | $363.08 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $363.08 Typical High $371.54 | Professional | None | $309.03 | $363.08 | $371.54 |
United Setting Professional Modifier None Typical Low $331.13 Median $371.54 Typical High $398.11 | Professional | None | $331.13 | $371.54 | $398.11 |
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 $165.96 Median $165.96 Typical High $199.53 | Professional | 52 · Reduced service | $165.96 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $79.43 | Professional | 53 · Discontinued | $67.61 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $58.88 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $39.81 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $39.81 |
Where Missouri sits
The same service costs 3.0 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· 13th of 51
$372
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.