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 $43.65 Median $52.48 Typical High $72.44 | Facility | None | $43.65 | $52.48 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $60.26 | Professional | None | $41.69 | $41.69 | $60.26 |
Anthem BCBS Setting Facility Modifier None Typical Low $41.69 Median $60.26 Typical High $117.49 | Facility | None | $41.69 | $60.26 | $117.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $48.98 Typical High $60.26 | Professional | None | $41.69 | $48.98 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $72.44 Typical High $100.00 | Facility | None | $47.86 | $72.44 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Professional | None | $41.69 | $41.69 | $41.69 |
Medica Setting Facility Modifier None Typical Low $25.12 Median $52.48 Typical High $218.78 | Facility | None | $25.12 | $52.48 | $218.78 |
Medica Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $50.12 | Professional | None | $33.88 | $33.88 | $50.12 |
United Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $51.29 | Professional | None | $44.67 | $44.67 | $51.29 |
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 $20.89 Median $20.89 Typical High $30.20 | Professional | 52 · Reduced service | $20.89 | $20.89 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $8.32 Typical High $12.02 | Professional | 53 · Discontinued | $8.32 | $8.32 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $8.91 | Professional | 55 · Aftercare only | $6.31 | $6.31 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.17 Typical High $6.03 | Professional | 56 · Pre-op care only | $4.17 | $4.17 | $6.03 |
Where Missouri sits
The same service costs 1.8 times more in Arizona than in Georgia. 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
$44.67
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.