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 $35.48 Median $35.48 Typical High $43.65 | Facility | None | $35.48 | $35.48 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $35.48 Typical High $43.65 | Professional | None | $22.39 | $35.48 | $43.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $9.33 Median $11.22 Typical High $25.12 | Professional | None | $9.33 | $11.22 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Medica Setting Facility Modifier None Typical Low $38.90 Median $44.67 Typical High $123.03 | Facility | None | $38.90 | $44.67 | $123.03 |
Medica Setting Professional Modifier None Typical Low $23.99 Median $64.57 Typical High $151.36 | Professional | None | $23.99 | $64.57 | $151.36 |
United Setting Professional Modifier None Typical Low $22.91 Median $26.30 Typical High $48.98 | Professional | None | $22.91 | $26.30 | $48.98 |
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 $11.22 Median $17.78 Typical High $21.88 | Professional | 52 · Reduced service | $11.22 | $17.78 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $7.08 Typical High $8.71 | Professional | 53 · Discontinued | $4.57 | $7.08 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $5.25 Typical High $6.61 | Professional | 55 · Aftercare only | $3.39 | $5.25 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $3.55 Typical High $4.37 | Professional | 56 · Pre-op care only | $2.24 | $3.55 | $4.37 |
Where Missouri sits
The same service costs 2.7 times more in Alaska than in Connecticut. 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· 20th of 51
$28.84
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.