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 $97.72 Median $147.91 Typical High $208.93 | Facility | None | $97.72 | $147.91 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $97.72 Typical High $131.83 | Professional | None | $57.54 | $97.72 | $131.83 |
Ambetter Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $57.54 | Professional | None | $48.98 | $48.98 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $524.81 | Facility | None | $114.82 | $114.82 | $524.81 |
Anthem BCBS Setting Professional Modifier None Typical Low $45.71 Median $56.23 Typical High $131.83 | Professional | None | $45.71 | $56.23 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $251.19 Typical High $489.78 | Facility | None | $81.28 | $251.19 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Medica Setting Facility Modifier None Typical Low $38.90 Median $147.91 Typical High $549.54 | Facility | None | $38.90 | $147.91 | $549.54 |
Medica Setting Professional Modifier None Typical Low $47.86 Median $69.18 Typical High $138.04 | Professional | None | $47.86 | $69.18 | $138.04 |
United Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
United Setting Professional Modifier None Typical Low $47.86 Median $69.18 Typical High $151.36 | Professional | None | $47.86 | $69.18 | $151.36 |
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 $48.98 Median $48.98 Typical High $66.07 | Professional | 52 · Reduced service | $48.98 | $48.98 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $26.30 | Professional | 53 · Discontinued | $19.50 | $19.50 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $74.13 Typical High $91.20 | Professional | 54 · Surgery only | $72.44 | $74.13 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.79 Typical High $19.95 | Professional | 55 · Aftercare only | $14.45 | $14.79 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $13.18 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $13.18 |
Where Missouri sits
The same service costs 4.9 times more in Alaska than in Georgia. 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· 41st of 51
$79.43
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.