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 $39.81 Median $45.71 Typical High $63.10 | Facility | None | $39.81 | $45.71 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $47.86 | Professional | None | $39.81 | $39.81 | $47.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $41.69 Median $53.70 Typical High $138.04 | Facility | None | $41.69 | $53.70 | $138.04 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.88 Median $43.65 Typical High $45.71 | Professional | None | $33.88 | $43.65 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $64.57 Typical High $72.44 | Facility | None | $43.65 | $64.57 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Professional | None | $38.90 | $38.90 | $38.90 |
Medica Setting Facility Modifier None Typical Low $39.81 Median $47.86 Typical High $199.53 | Facility | None | $39.81 | $47.86 | $199.53 |
Medica Setting Professional Modifier None Typical Low $36.31 Median $39.81 Typical High $44.67 | Professional | None | $36.31 | $39.81 | $44.67 |
United Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
United Setting Professional Modifier None Typical Low $36.31 Median $39.81 Typical High $45.71 | Professional | None | $36.31 | $39.81 | $45.71 |
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 $19.95 Median $19.95 Typical High $23.99 | Professional | 52 · Reduced service | $19.95 | $19.95 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $9.55 | Professional | 53 · Discontinued | $7.94 | $7.94 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $7.24 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $4.79 |
Where Missouri sits
The same service costs 1.6 times more in Arizona than in Wyoming. 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· 21st of 51
$39.81
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.