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 $5.01 Median $10.00 Typical High $41.69 | Facility | None | $5.01 | $10.00 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $5.01 Median $10.00 Typical High $20.42 | Professional | None | $5.01 | $10.00 | $20.42 |
Ambetter Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | None | $19.95 | $19.95 | $19.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.01 Median $6.92 Typical High $20.42 | Professional | None | $5.01 | $6.92 | $20.42 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
Medica Setting Facility Modifier None Typical Low $18.20 Median $45.71 Typical High $181.97 | Facility | None | $18.20 | $45.71 | $181.97 |
Medica Setting Professional Modifier None Typical Low $13.18 Median $23.44 Typical High $36.31 | Professional | None | $13.18 | $23.44 | $36.31 |
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 $13.18 Median $25.12 Typical High $54.95 | Professional | None | $13.18 | $25.12 | $54.95 |
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 $2.51 Median $5.01 Typical High $5.01 | Professional | 52 · Reduced service | $2.51 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.00 Median $2.00 Typical High $2.00 | Professional | 53 · Discontinued | $1.00 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.76 Median $1.51 Typical High $1.51 | Professional | 55 · Aftercare only | $0.76 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.50 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.50 | $1.00 | $1.00 |
Where Missouri sits
The same service costs 4.6 times more in Alabama than in Missouri. 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· 51st of 51
$12.30
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.