How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $16.98 Median $16.98 Typical High $19.50 | Facility | None | $16.98 | $16.98 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $16.98 Median $17.78 Typical High $19.50 | Professional | None | $16.98 | $17.78 | $19.50 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,659.59 | Facility | None | $1,479.11 | $1,479.11 | $1,659.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.78 Median $22.39 Typical High $33.11 | Professional | None | $17.78 | $22.39 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $26.30 Typical High $48.98 | Professional | None | $18.62 | $26.30 | $48.98 |
Medica Setting Facility Modifier None Typical Low $16.98 Median $45.71 Typical High $100.00 | Facility | None | $16.98 | $45.71 | $100.00 |
Medica Setting Professional Modifier None Typical Low $17.38 Median $28.18 Typical High $39.81 | Professional | None | $17.38 | $28.18 | $39.81 |
United Setting Professional Modifier None Typical Low $17.78 Median $27.54 Typical High $40.74 | Professional | None | $17.78 | $27.54 | $40.74 |
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 $8.51 Median $8.91 Typical High $9.55 | Professional | 52 · Reduced service | $8.51 | $8.91 | $9.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $3.55 Typical High $3.89 | Professional | 53 · Discontinued | $3.39 | $3.55 | $3.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $2.63 Typical High $2.88 | Professional | 55 · Aftercare only | $2.51 | $2.63 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $1.78 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.70 | $1.78 | $1.95 |
Where Missouri sits
The same service costs 4.3 times more in Alaska than in New York. 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· 42nd of 51
$22.91
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.