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 $51.29 Median $64.57 Typical High $89.13 | Facility | None | $51.29 | $64.57 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $64.57 | Professional | None | $51.29 | $51.29 | $64.57 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.02 Median $0.02 Typical High $0.03 | Facility | None | $0.02 | $0.02 | $0.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $47.86 Median $64.57 Typical High $64.57 | Professional | None | $47.86 | $64.57 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $89.13 Typical High $102.33 | Facility | None | $61.66 | $89.13 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Medica Setting Facility Modifier None Typical Low $28.84 Median $74.13 Typical High $302.00 | Facility | None | $28.84 | $74.13 | $302.00 |
Medica Setting Professional Modifier None Typical Low $54.95 Median $56.23 Typical High $64.57 | Professional | None | $54.95 | $56.23 | $64.57 |
United Setting Professional Modifier None Typical Low $51.29 Median $56.23 Typical High $64.57 | Professional | None | $51.29 | $56.23 | $64.57 |
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 $25.70 Median $25.70 Typical High $32.36 | Professional | 52 · Reduced service | $25.70 | $25.70 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $10.23 Typical High $12.88 | Professional | 53 · Discontinued | $10.23 | $10.23 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $7.76 Typical High $9.55 | Professional | 55 · Aftercare only | $7.76 | $7.76 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $5.13 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.13 | $5.13 | $6.46 |
Where Missouri sits
The same service costs 1.6 times more in Arizona than in California. 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· 27th of 51
$56.23
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.