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 $42.66 Median $50.12 Typical High $69.18 | Facility | None | $42.66 | $50.12 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $52.48 | Professional | None | $43.65 | $43.65 | $52.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $44.67 Median $58.88 Typical High $151.36 | Facility | None | $44.67 | $58.88 | $151.36 |
Anthem BCBS Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $50.12 | Professional | None | $42.66 | $46.77 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $95.50 Typical High $112.20 | Facility | None | $54.95 | $95.50 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Medica Setting Facility Modifier None Typical Low $39.81 Median $47.86 Typical High $204.17 | Facility | None | $39.81 | $47.86 | $204.17 |
Medica Setting Professional Modifier None Typical Low $38.02 Median $41.69 Typical High $47.86 | Professional | None | $38.02 | $41.69 | $47.86 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
United Setting Professional Modifier None Typical Low $39.81 Median $42.66 Typical High $48.98 | Professional | None | $39.81 | $42.66 | $48.98 |
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 $21.88 Median $21.88 Typical High $26.30 | Professional | 52 · Reduced service | $21.88 | $21.88 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $8.71 Typical High $10.47 | Professional | 53 · Discontinued | $8.71 | $8.71 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $7.76 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $4.37 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.37 | $4.37 | $5.25 |
Where Missouri sits
The same service costs 1.6 times more in Arizona than in Maryland. 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· 19th of 51
$43.65
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.