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 $131.83 Median $131.83 Typical High $162.18 | Facility | None | $131.83 | $131.83 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $158.49 Typical High $162.18 | Professional | None | $131.83 | $158.49 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $144.54 | Professional | None | $144.54 | $144.54 | $144.54 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $346.74 Typical High $933.25 | Facility | None | $204.17 | $346.74 | $933.25 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $331.13 | Professional | None | $169.82 | $245.47 | $331.13 |
United Setting Professional Modifier None Typical Low $173.78 Median $257.04 Typical High $338.84 | Professional | None | $173.78 | $257.04 | $338.84 |
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 $66.07 Median $79.43 Typical High $81.28 | Professional | 52 · Reduced service | $66.07 | $79.43 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $31.62 Typical High $32.36 | Professional | 53 · Discontinued | $26.30 | $31.62 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $23.44 Typical High $24.55 | Professional | 55 · Aftercare only | $19.50 | $23.44 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $15.85 Typical High $16.22 | Professional | 56 · Pre-op care only | $13.18 | $15.85 | $16.22 |
Where Missouri sits
The same service costs 4.7 times more in Alaska than in Alabama. 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· 19th of 51
$219
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.