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 $81.28 Median $87.10 Typical High $134.90 | Facility | None | $81.28 | $87.10 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $100.00 | Professional | None | $83.18 | $83.18 | $100.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $85.11 Median $112.20 Typical High $281.84 | Facility | None | $85.11 | $112.20 | $281.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $97.72 | Professional | None | $81.28 | $89.13 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $102.33 Typical High $245.47 | Facility | None | $95.50 | $102.33 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
Medica Setting Facility Modifier None Typical Low $77.62 Median $93.33 Typical High $389.05 | Facility | None | $77.62 | $93.33 | $389.05 |
Medica Setting Professional Modifier None Typical Low $72.44 Median $81.28 Typical High $91.20 | Professional | None | $72.44 | $81.28 | $91.20 |
United Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
United Setting Professional Modifier None Typical Low $77.62 Median $81.28 Typical High $93.33 | Professional | None | $77.62 | $81.28 | $93.33 |
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 $41.69 Median $41.69 Typical High $50.12 | Professional | 52 · Reduced service | $41.69 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $19.95 | Professional | 53 · Discontinued | $16.98 | $16.98 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $15.14 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $10.00 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $10.00 |
Where Missouri sits
The same service costs 446.7 times more in Alabama than in Iowa. 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· 31st of 51
$83.18
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.