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 $21.88 Median $23.44 Typical High $23.44 | Facility | None | $21.88 | $23.44 | $23.44 |
Aetna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $23.44 | Professional | None | $21.88 | $21.88 | $23.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $21.88 Median $25.12 Typical High $77.62 | Facility | None | $21.88 | $25.12 | $77.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.39 Median $23.44 Typical High $23.44 | Professional | None | $22.39 | $23.44 | $23.44 |
Cigna Setting Facility Modifier None Typical Low $23.44 Median $36.31 Typical High $40.74 | Facility | None | $23.44 | $36.31 | $40.74 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
Medica Setting Facility Modifier None Typical Low $15.85 Median $27.54 Typical High $100.00 | Facility | None | $15.85 | $27.54 | $100.00 |
Medica Setting Professional Modifier None Typical Low $19.50 Median $23.44 Typical High $23.99 | Professional | None | $19.50 | $23.44 | $23.99 |
United Setting Professional Modifier None Typical Low $22.39 Median $24.55 Typical High $26.92 | Professional | None | $22.39 | $24.55 | $26.92 |
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 $10.96 Median $10.96 Typical High $11.75 | Professional | 52 · Reduced service | $10.96 | $10.96 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.37 Median $4.37 Typical High $4.68 | Professional | 53 · Discontinued | $4.37 | $4.37 | $4.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.31 Median $3.31 Typical High $3.47 | Professional | 55 · Aftercare only | $3.31 | $3.31 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.19 Typical High $2.29 | Professional | 56 · Pre-op care only | $2.19 | $2.19 | $2.29 |
Where Missouri sits
The same service costs 1.9 times more in Alabama than in Georgia. 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· 18th of 51
$23.44
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.