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 $51.29 Median $54.95 Typical High $75.86 | Facility | None | $51.29 | $54.95 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $75.86 | Professional | None | $53.70 | $53.70 | $75.86 |
Anthem BCBS Setting Facility Modifier None Typical Low $53.70 Median $72.44 Typical High $141.25 | Facility | None | $53.70 | $72.44 | $141.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $57.54 Typical High $61.66 | Professional | None | $51.29 | $57.54 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $93.33 Typical High $125.89 | Facility | None | $61.66 | $93.33 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Medica Setting Facility Modifier None Typical Low $33.11 Median $50.12 Typical High $169.82 | Facility | None | $33.11 | $50.12 | $169.82 |
Medica Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $53.70 | Professional | None | $42.66 | $46.77 | $53.70 |
United Setting Professional Modifier None Typical Low $48.98 Median $51.29 Typical High $60.26 | Professional | None | $48.98 | $51.29 | $60.26 |
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 $26.92 Median $26.92 Typical High $32.36 | Professional | 52 · Reduced service | $26.92 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $12.88 | Professional | 53 · Discontinued | $10.72 | $10.72 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $8.13 Typical High $9.77 | Professional | 55 · Aftercare only | $8.13 | $8.13 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $6.46 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $6.46 |
Where Missouri sits
The same service costs 3.0 times more in Arizona 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· 36th of 51
$53.70
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.