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 $4.90 Median $11.75 Typical High $11.75 | Facility | None | $4.90 | $11.75 | $11.75 |
Aetna Setting Professional Modifier None Typical Low $4.90 Median $10.00 Typical High $11.75 | Professional | None | $4.90 | $10.00 | $11.75 |
Anthem BCBS Setting Facility Modifier None Typical Low $22.39 Median $40.74 Typical High $72.44 | Facility | None | $22.39 | $40.74 | $72.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.96 Median $11.48 Typical High $389.05 | Professional | None | $10.96 | $11.48 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $10.96 Median $15.85 Typical High $18.20 | Facility | None | $10.96 | $15.85 | $18.20 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Professional | None | $9.77 | $9.77 | $9.77 |
Medica Setting Facility Modifier None Typical Low $6.17 Median $21.88 Typical High $104.71 | Facility | None | $6.17 | $21.88 | $104.71 |
Medica Setting Professional Modifier None Typical Low $5.75 Median $74.13 Typical High $74.13 | Professional | None | $5.75 | $74.13 | $74.13 |
United Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
United Setting Professional Modifier None Typical Low $4.79 Median $6.92 Typical High $9.55 | Professional | None | $4.79 | $6.92 | $9.55 |
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 $2.45 Median $5.01 Typical High $5.89 | Professional | 52 · Reduced service | $2.45 | $5.01 | $5.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.00 Median $2.19 Typical High $2.34 | Professional | 53 · Discontinued | $1.00 | $2.19 | $2.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.74 Median $1.62 Typical High $1.74 | Professional | 55 · Aftercare only | $0.74 | $1.62 | $1.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.49 Median $1.10 Typical High $1.17 | Professional | 56 · Pre-op care only | $0.49 | $1.10 | $1.17 |
Where Missouri sits
The same service costs 46.8 times more in New York than in Arkansas. 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· 31st of 51
$9.77
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.