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 $112.20 Median $141.25 Typical High $194.98 | Facility | None | $112.20 | $141.25 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $141.25 | Professional | None | $112.20 | $112.20 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $102.33 Median $134.90 Typical High $338.84 | Facility | None | $102.33 | $134.90 | $338.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $107.15 Median $141.25 Typical High $141.25 | Professional | None | $107.15 | $141.25 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $199.53 Typical High $223.87 | Facility | None | $134.90 | $199.53 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Medica Setting Facility Modifier None Typical Low $97.72 Median $141.25 Typical High $537.03 | Facility | None | $97.72 | $141.25 | $537.03 |
Medica Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $138.04 | Professional | None | $117.49 | $117.49 | $138.04 |
United Setting Facility Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Facility | None | $95.50 | $95.50 | $95.50 |
United Setting Professional Modifier None Typical Low $112.20 Median $117.49 Typical High $134.90 | Professional | None | $112.20 | $117.49 | $134.90 |
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 $56.23 Median $56.23 Typical High $70.79 | Professional | 52 · Reduced service | $56.23 | $56.23 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $22.91 Typical High $28.18 | Professional | 53 · Discontinued | $22.91 | $22.91 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $16.98 Typical High $21.38 | Professional | 55 · Aftercare only | $16.98 | $16.98 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $14.13 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $14.13 |
Where Missouri sits
The same service costs 2.3 times more in Texas than in Hawaii. 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· 48th of 51
$117
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.