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 $218.78 Median $218.78 Typical High $269.15 | Facility | None | $218.78 | $218.78 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $218.78 Median $263.03 Typical High $269.15 | Professional | None | $218.78 | $263.03 | $269.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $190.55 Median $208.93 Typical High $263.03 | Professional | None | $190.55 | $208.93 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Professional | None | $204.17 | $204.17 | $204.17 |
Medica Setting Facility Modifier None Typical Low $239.88 Median $457.09 Typical High $1,258.93 | Facility | None | $239.88 | $457.09 | $1,258.93 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $501.19 | Professional | None | $208.93 | $302.00 | $501.19 |
United Setting Professional Modifier None Typical Low $208.93 Median $316.23 Typical High $588.84 | Professional | None | $208.93 | $316.23 | $588.84 |
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 $109.65 Median $131.83 Typical High $134.90 | Professional | 52 · Reduced service | $109.65 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $52.48 Typical High $53.70 | Professional | 53 · Discontinued | $43.65 | $52.48 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $39.81 Typical High $39.81 | Professional | 55 · Aftercare only | $32.36 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $26.30 Typical High $26.92 | Professional | 56 · Pre-op care only | $21.88 | $26.30 | $26.92 |
Where Missouri sits
The same service costs 26.9 times more in Alaska than in Virginia. 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· 32nd of 51
$234
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.