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 $30.90 Median $3,162.28 Typical High $7,762.47 | Facility | None | $30.90 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $22.39 Typical High $2,511.89 | Professional | None | $17.38 | $22.39 | $2,511.89 |
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 $19.50 Median $22.91 Typical High $29.51 | Professional | None | $19.50 | $22.91 | $29.51 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $102.33 Typical High $125.89 | Facility | None | $70.79 | $102.33 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $20.89 Typical High $39.81 | Professional | None | $16.60 | $20.89 | $39.81 |
Medica Setting Facility Modifier None Typical Low $18.20 Median $70.79 Typical High $144.54 | Facility | None | $18.20 | $70.79 | $144.54 |
Medica Setting Professional Modifier None Typical Low $18.62 Median $26.30 Typical High $47.86 | Professional | None | $18.62 | $26.30 | $47.86 |
United Setting Facility Modifier None Typical Low $147.91 Median $147.91 Typical High $154.88 | Facility | None | $147.91 | $147.91 | $154.88 |
United Setting Professional Modifier None Typical Low $18.62 Median $29.51 Typical High $48.98 | Professional | None | $18.62 | $29.51 | $48.98 |
5 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 $8.71 Median $9.55 Typical High $11.22 | Professional | 52 · Reduced service | $8.71 | $9.55 | $11.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $3.80 Typical High $4.47 | Professional | 53 · Discontinued | $3.55 | $3.80 | $4.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $2.88 Typical High $3.39 | Professional | 55 · Aftercare only | $2.63 | $2.88 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.91 Typical High $2.24 | Professional | 56 · Pre-op care only | $1.74 | $1.91 | $2.24 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $21.38 Median $21.38 Typical High $21.38 | Professional | 59 · Distinct service | $21.38 | $21.38 | $21.38 |
Where Missouri sits
The same service costs 40.7 times more in Tennessee 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· 44th of 51
$23.44
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.