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 $162.18 Median $234.42 Typical High $331.13 | Facility | None | $162.18 | $234.42 | $331.13 |
Aetna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $239.88 | Professional | None | $165.96 | $165.96 | $239.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $169.82 Median $223.87 Typical High $575.44 | Facility | None | $169.82 | $223.87 | $575.44 |
Anthem BCBS Setting Professional Modifier None Typical Low $162.18 Median $177.83 Typical High $239.88 | Professional | None | $162.18 | $177.83 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $281.84 Typical High $389.05 | Facility | None | $190.55 | $281.84 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $218.78 Typical High $851.14 | Facility | None | $169.82 | $218.78 | $851.14 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $169.82 Typical High $194.98 | Professional | None | $151.36 | $169.82 | $194.98 |
United Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
United Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $190.55 | Professional | None | $162.18 | $162.18 | $190.55 |
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 $83.18 Median $83.18 Typical High $120.23 | Professional | 52 · Reduced service | $83.18 | $83.18 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $33.11 Typical High $47.86 | Professional | 53 · Discontinued | $33.11 | $33.11 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $24.55 Typical High $36.31 | Professional | 55 · Aftercare only | $24.55 | $24.55 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $16.60 Typical High $23.99 | Professional | 56 · Pre-op care only | $16.60 | $16.60 | $23.99 |
Where Missouri sits
The same service costs 1.6 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· 24th of 51
$170
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.