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 $75.86 Median $75.86 Typical High $87.10 | Facility | None | $75.86 | $75.86 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $87.10 | Professional | None | $75.86 | $75.86 | $87.10 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $87.10 Typical High $263.03 | Facility | None | $75.86 | $87.10 | $263.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $87.10 Typical High $87.10 | Professional | None | $75.86 | $87.10 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $134.90 Typical High $151.36 | Facility | None | $87.10 | $134.90 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
Medica Setting Facility Modifier None Typical Low $74.13 Median $79.43 Typical High $302.00 | Facility | None | $74.13 | $79.43 | $302.00 |
Medica Setting Professional Modifier None Typical Low $69.18 Median $81.28 Typical High $83.18 | Professional | None | $69.18 | $81.28 | $83.18 |
United Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
United Setting Professional Modifier None Typical Low $72.44 Median $81.28 Typical High $87.10 | Professional | None | $72.44 | $81.28 | $87.10 |
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 $37.15 Median $37.15 Typical High $43.65 | Professional | 52 · Reduced service | $37.15 | $37.15 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $17.38 | Professional | 53 · Discontinued | $15.14 | $15.14 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $12.88 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $8.71 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $8.71 |
Where Missouri sits
The same service costs 3.0 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· 26th of 51
$81.28
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.