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 $263.03 Median $309.03 Typical High $309.03 | Facility | None | $263.03 | $309.03 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $309.03 | Professional | None | $263.03 | $263.03 | $309.03 |
Anthem BCBS Setting Facility Modifier None Typical Low $257.04 Median $346.74 Typical High $676.08 | Facility | None | $257.04 | $346.74 | $676.08 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $478.63 Typical High $537.03 | Facility | None | $309.03 | $478.63 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $269.15 Typical High $933.25 | Facility | None | $169.82 | $269.15 | $933.25 |
Medica Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $281.84 | Professional | None | $234.42 | $275.42 | $281.84 |
United Setting Professional Modifier None Typical Low $257.04 Median $288.40 Typical High $309.03 | Professional | None | $257.04 | $288.40 | $309.03 |
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 $131.83 Median $131.83 Typical High $154.88 | Professional | 52 · Reduced service | $131.83 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $61.66 | Professional | 53 · Discontinued | $52.48 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $45.71 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $30.90 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $30.90 |
Where Missouri sits
The same service costs 3.9 times more in Arizona than in Montana. 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· 12th of 51
$288
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.