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 $38.90 Median $48.98 Typical High $58.88 | Facility | None | $38.90 | $48.98 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $57.54 | Professional | None | $40.74 | $40.74 | $57.54 |
Ambetter Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $50.12 | Professional | None | $33.11 | $33.11 | $50.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $40.74 Median $54.95 Typical High $107.15 | Facility | None | $40.74 | $54.95 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $54.95 Typical High $54.95 | Professional | None | $46.77 | $54.95 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $85.11 Typical High $95.50 | Facility | None | $57.54 | $85.11 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | None | $51.29 | $51.29 | $51.29 |
Medica Setting Facility Modifier None Typical Low $29.51 Median $47.86 Typical High $147.91 | Facility | None | $29.51 | $47.86 | $147.91 |
Medica Setting Professional Modifier None Typical Low $42.66 Median $48.98 Typical High $51.29 | Professional | None | $42.66 | $48.98 | $51.29 |
United Setting Professional Modifier None Typical Low $45.71 Median $51.29 Typical High $54.95 | Professional | None | $45.71 | $51.29 | $54.95 |
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 $20.42 Median $20.42 Typical High $27.54 | Professional | 52 · Reduced service | $20.42 | $20.42 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.13 Typical High $10.96 | Professional | 53 · Discontinued | $8.13 | $8.13 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.17 Typical High $8.13 | Professional | 55 · Aftercare only | $6.17 | $6.17 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.07 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.07 | $4.07 | $5.50 |
Where Missouri sits
The same service costs 6.0 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· 15th of 51
$51.29
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.