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 $331.13 Median $389.05 Typical High $549.54 | Facility | None | $331.13 | $389.05 | $549.54 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $407.38 | Professional | None | $338.84 | $338.84 | $407.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $346.74 Median $457.09 Typical High $1,148.15 | Facility | None | $346.74 | $457.09 | $1,148.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $389.05 | Professional | None | $331.13 | $363.08 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $575.44 Typical High $794.33 | Facility | None | $389.05 | $575.44 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Professional | None | $338.84 | $338.84 | $338.84 |
Medica Setting Facility Modifier None Typical Low $323.59 Median $380.19 Typical High $1,584.89 | Facility | None | $323.59 | $380.19 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $331.13 Typical High $371.54 | Professional | None | $295.12 | $331.13 | $371.54 |
United Setting Facility Modifier None Typical Low $338.84 Median $338.84 Typical High $338.84 | Facility | None | $338.84 | $338.84 | $338.84 |
United Setting Professional Modifier None Typical Low $309.03 Median $331.13 Typical High $380.19 | Professional | None | $309.03 | $331.13 | $380.19 |
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 $169.82 Median $169.82 Typical High $204.17 | Professional | 52 · Reduced service | $169.82 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $81.28 | Professional | 53 · Discontinued | $67.61 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $50.12 Typical High $60.26 | Professional | 55 · Aftercare only | $50.12 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $40.74 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $40.74 |
Where Missouri sits
The same service costs 1.5 times more in Arizona than in Rhode Island. 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· 22nd of 51
$339
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.