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 $70.79 Median $70.79 Typical High $87.10 | Facility | None | $70.79 | $70.79 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $13.80 Median $70.79 Typical High $87.10 | Professional | None | $13.80 | $70.79 | $87.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.75 Median $6.76 Typical High $15.14 | Professional | None | $5.75 | $6.76 | $15.14 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
Medica Setting Facility Modifier None Typical Low $26.92 Median $75.86 Typical High $87.10 | Facility | None | $26.92 | $75.86 | $87.10 |
Medica Setting Professional Modifier None Typical Low $14.45 Median $91.20 Typical High $91.20 | Professional | None | $14.45 | $91.20 | $91.20 |
United Setting Professional Modifier None Typical Low $13.49 Median $15.85 Typical High $38.90 | Professional | None | $13.49 | $15.85 | $38.90 |
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 $6.92 Median $35.48 Typical High $43.65 | Professional | 52 · Reduced service | $6.92 | $35.48 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.75 Median $14.13 Typical High $17.38 | Professional | 53 · Discontinued | $2.75 | $14.13 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $10.72 Typical High $13.18 | Professional | 55 · Aftercare only | $2.04 | $10.72 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.38 Median $7.08 Typical High $8.71 | Professional | 56 · Pre-op care only | $1.38 | $7.08 | $8.71 |
Where Missouri sits
The same service costs 4.9 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
$16.98
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.