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 $11.22 Median $12.02 Typical High $21.38 | Facility | None | $11.22 | $12.02 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $17.38 | Professional | None | $11.22 | $11.22 | $17.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.22 Median $15.14 Typical High $29.51 | Facility | None | $11.22 | $15.14 | $29.51 |
Anthem BCBS Setting Professional Modifier None Typical Low $11.22 Median $12.59 Typical High $17.38 | Professional | None | $11.22 | $12.59 | $17.38 |
Cigna Setting Facility Modifier None Typical Low $12.88 Median $19.05 Typical High $26.30 | Facility | None | $12.88 | $19.05 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
Medica Setting Facility Modifier None Typical Low $8.51 Median $12.88 Typical High $100.00 | Facility | None | $8.51 | $12.88 | $100.00 |
Medica Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $10.72 | Professional | None | $8.32 | $8.32 | $10.72 |
United Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $13.80 | Professional | None | $11.22 | $11.22 | $13.80 |
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 $5.62 Median $5.62 Typical High $8.71 | Professional | 52 · Reduced service | $5.62 | $5.62 | $8.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.24 Typical High $3.47 | Professional | 53 · Discontinued | $2.24 | $2.24 | $3.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $1.66 Typical High $2.63 | Professional | 55 · Aftercare only | $1.66 | $1.66 | $2.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.12 Typical High $1.74 | Professional | 56 · Pre-op care only | $1.12 | $1.12 | $1.74 |
Where Missouri sits
The same service costs 3.3 times more in Alaska than in Texas. 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· 39th of 51
$11.22
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.