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 $269.15 Median $269.15 Typical High $288.40 | Facility | None | $269.15 | $269.15 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $323.59 | Professional | None | $269.15 | $269.15 | $323.59 |
Ambetter Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $269.15 | Professional | None | $229.09 | $229.09 | $269.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $269.15 Median $309.03 Typical High $933.25 | Facility | None | $269.15 | $309.03 | $933.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $275.42 Median $288.40 Typical High $288.40 | Professional | None | $275.42 | $288.40 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $446.68 Typical High $501.19 | Facility | None | $288.40 | $446.68 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
Medica Setting Facility Modifier None Typical Low $251.19 Median $316.23 Typical High $1,000.00 | Facility | None | $251.19 | $316.23 | $1,000.00 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $275.42 | Professional | None | $229.09 | $269.15 | $275.42 |
United Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
United Setting Professional Modifier None Typical Low $239.88 Median $269.15 Typical High $288.40 | Professional | None | $239.88 | $269.15 | $288.40 |
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 $134.90 Median $134.90 Typical High $144.54 | Professional | 52 · Reduced service | $134.90 | $134.90 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $53.70 Typical High $57.54 | Professional | 53 · Discontinued | $53.70 | $53.70 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $40.74 Typical High $43.65 | Professional | 55 · Aftercare only | $40.74 | $40.74 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $26.92 Typical High $28.84 | Professional | 56 · Pre-op care only | $26.92 | $26.92 | $28.84 |
Where Missouri sits
The same service costs 2.3 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· 23rd of 51
$275
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.