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 $14.13 Median $33.88 Typical High $40.74 | Facility | None | $14.13 | $33.88 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $33.88 | Professional | None | $14.45 | $14.45 | $33.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $14.45 Median $19.50 Typical High $38.02 | Facility | None | $14.45 | $19.50 | $38.02 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.13 Median $15.85 Typical High $33.88 | Professional | None | $14.13 | $15.85 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $25.12 Typical High $33.88 | Facility | None | $16.60 | $25.12 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | None | $14.45 | $14.45 | $14.45 |
Medica Setting Facility Modifier None Typical Low $14.13 Median $29.51 Typical High $100.00 | Facility | None | $14.13 | $29.51 | $100.00 |
Medica Setting Professional Modifier None Typical Low $10.23 Median $11.48 Typical High $13.18 | Professional | None | $10.23 | $11.48 | $13.18 |
United Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $17.78 | Professional | None | $14.13 | $14.13 | $17.78 |
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 $7.24 Median $7.24 Typical High $16.98 | Professional | 52 · Reduced service | $7.24 | $7.24 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $2.88 Typical High $6.76 | Professional | 53 · Discontinued | $2.88 | $2.88 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.19 Median $2.19 Typical High $5.01 | Professional | 55 · Aftercare only | $2.19 | $2.19 | $5.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $1.45 Typical High $3.39 | Professional | 56 · Pre-op care only | $1.45 | $1.45 | $3.39 |
Where Missouri sits
The same service costs 2.0 times more in Wyoming than in Oklahoma. 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· 37th of 51
$14.45
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.