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 $177.83 Median $177.83 Typical High $218.78 | Facility | None | $177.83 | $177.83 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $177.83 Typical High $218.78 | Professional | None | $81.28 | $177.83 | $218.78 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.88 Median $39.81 Typical High $91.20 | Professional | None | $33.88 | $39.81 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | None | $70.79 | $70.79 | $70.79 |
Medica Setting Facility Modifier None Typical Low $162.18 Median $204.17 Typical High $446.68 | Facility | None | $162.18 | $204.17 | $446.68 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $269.15 Typical High $537.03 | Professional | None | $87.10 | $269.15 | $537.03 |
United Setting Professional Modifier None Typical Low $83.18 Median $95.50 Typical High $234.42 | Professional | None | $83.18 | $95.50 | $234.42 |
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 $40.74 Median $89.13 Typical High $109.65 | Professional | 52 · Reduced service | $40.74 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $35.48 Typical High $43.65 | Professional | 53 · Discontinued | $16.60 | $35.48 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $26.92 Typical High $33.11 | Professional | 55 · Aftercare only | $12.30 | $26.92 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $17.78 Typical High $21.88 | Professional | 56 · Pre-op care only | $8.13 | $17.78 | $21.88 |
Where Missouri sits
The same service costs 3.6 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· 18th of 51
$105
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.