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 $165.96 Median $169.82 Typical High $234.42 | Facility | None | $165.96 | $169.82 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $234.42 | Professional | None | $169.82 | $169.82 | $234.42 |
Anthem BCBS Setting Facility Modifier None Typical Low $173.78 Median $229.09 Typical High $575.44 | Facility | None | $173.78 | $229.09 | $575.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $234.42 | Professional | None | $199.53 | $234.42 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $363.08 Typical High $407.38 | Facility | None | $234.42 | $363.08 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Medica Setting Facility Modifier None Typical Low $154.88 Median $213.80 Typical High $812.83 | Facility | None | $154.88 | $213.80 | $812.83 |
Medica Setting Professional Modifier None Typical Low $165.96 Median $194.98 Typical High $223.87 | Professional | None | $165.96 | $194.98 | $223.87 |
United Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
United Setting Professional Modifier None Typical Low $165.96 Median $186.21 Typical High $229.09 | Professional | None | $165.96 | $186.21 | $229.09 |
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 $85.11 Median $85.11 Typical High $117.49 | Professional | 52 · Reduced service | $85.11 | $85.11 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $46.77 | Professional | 53 · Discontinued | $33.88 | $33.88 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $35.48 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $23.44 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $23.44 |
Where Missouri sits
The same service costs 1.8 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· 15th of 51
$219
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.