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 $42.66 Median $81.28 Typical High $100.00 | Facility | None | $42.66 | $81.28 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $54.95 Typical High $100.00 | Professional | None | $42.66 | $54.95 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $100.00 Typical High $117.49 | Professional | None | $93.33 | $100.00 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $138.04 Typical High $154.88 | Facility | None | $93.33 | $138.04 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Medica Setting Facility Modifier None Typical Low $52.48 Median $186.21 Typical High $512.86 | Facility | None | $52.48 | $186.21 | $512.86 |
Medica Setting Professional Modifier None Typical Low $38.02 Median $75.86 Typical High $630.96 | Professional | None | $38.02 | $75.86 | $630.96 |
United Setting Professional Modifier None Typical Low $33.88 Median $57.54 Typical High $138.04 | Professional | None | $33.88 | $57.54 | $138.04 |
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 $21.38 Median $27.54 Typical High $50.12 | Professional | 52 · Reduced service | $21.38 | $27.54 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $10.96 Typical High $19.95 | Professional | 53 · Discontinued | $8.51 | $10.96 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $8.13 Typical High $15.14 | Professional | 55 · Aftercare only | $6.31 | $8.13 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $5.50 Typical High $10.00 | Professional | 56 · Pre-op care only | $4.27 | $5.50 | $10.00 |
Where Missouri sits
The same service costs 5.0 times more in Ohio than in Hawaii. 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· 24th of 51
$83.18
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.