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 $23.99 Median $28.84 Typical High $57.54 | Facility | None | $23.99 | $28.84 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $37.15 | Professional | None | $24.55 | $24.55 | $37.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.12 Median $33.11 Typical High $85.11 | Facility | None | $25.12 | $33.11 | $85.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $23.99 Median $26.30 Typical High $28.84 | Professional | None | $23.99 | $26.30 | $28.84 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $42.66 Typical High $57.54 | Facility | None | $28.18 | $42.66 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Medica Setting Facility Modifier None Typical Low $22.91 Median $27.54 Typical High $114.82 | Facility | None | $22.91 | $27.54 | $114.82 |
Medica Setting Professional Modifier None Typical Low $21.38 Median $23.44 Typical High $27.54 | Professional | None | $21.38 | $23.44 | $27.54 |
United Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
United Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $27.54 | Professional | None | $23.99 | $23.99 | $27.54 |
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 $12.30 Median $12.30 Typical High $14.79 | Professional | 52 · Reduced service | $12.30 | $12.30 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.90 Median $4.90 Typical High $5.89 | Professional | 53 · Discontinued | $4.90 | $4.90 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $4.47 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.95 |
Where Missouri sits
The same service costs 1.6 times more in Alaska than in Mississippi. 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· 36th of 51
$24.55
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.