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 $93.33 Median $93.33 Typical High $117.49 | Facility | None | $93.33 | $93.33 | $117.49 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $93.33 Typical High $117.49 | Professional | None | $54.95 | $93.33 | $117.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $22.91 Median $26.92 Typical High $60.26 | Professional | None | $22.91 | $26.92 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $107.15 Typical High $295.12 | Facility | None | $104.71 | $107.15 | $295.12 |
Medica Setting Professional Modifier None Typical Low $57.54 Median $154.88 Typical High $363.08 | Professional | None | $57.54 | $154.88 | $363.08 |
United Setting Professional Modifier None Typical Low $54.95 Median $63.10 Typical High $131.83 | Professional | None | $54.95 | $63.10 | $131.83 |
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 $27.54 Median $46.77 Typical High $57.54 | Professional | 52 · Reduced service | $27.54 | $46.77 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $18.62 Typical High $23.44 | Professional | 53 · Discontinued | $10.96 | $18.62 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $14.13 Typical High $17.38 | Professional | 55 · Aftercare only | $8.13 | $14.13 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $9.33 Typical High $11.75 | Professional | 56 · Pre-op care only | $5.50 | $9.33 | $11.75 |
Where Missouri sits
The same service costs 3.0 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· 19th of 51
$70.79
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.