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 $54.95 Median $56.23 Typical High $128.82 | Facility | None | $54.95 | $56.23 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $109.65 | Professional | None | $54.95 | $54.95 | $109.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $54.95 Median $74.13 Typical High $144.54 | Facility | None | $54.95 | $74.13 | $144.54 |
Anthem BCBS Setting Professional Modifier None Typical Low $54.95 Median $60.26 Typical High $109.65 | Professional | None | $54.95 | $60.26 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $95.50 Typical High $128.82 | Facility | None | $63.10 | $95.50 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
Medica Setting Facility Modifier None Typical Low $47.86 Median $100.00 Typical High $371.54 | Facility | None | $47.86 | $100.00 | $371.54 |
Medica Setting Professional Modifier None Typical Low $85.11 Median $97.72 Typical High $112.20 | Professional | None | $85.11 | $97.72 | $112.20 |
United Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $69.18 | Professional | None | $54.95 | $54.95 | $69.18 |
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 $27.54 Median $27.54 Typical High $54.95 | Professional | 52 · Reduced service | $27.54 | $27.54 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $10.96 Typical High $21.88 | Professional | 53 · Discontinued | $10.96 | $10.96 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $8.32 Typical High $16.60 | Professional | 55 · Aftercare only | $8.32 | $8.32 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $5.50 Typical High $10.96 | Professional | 56 · Pre-op care only | $5.50 | $5.50 | $10.96 |
Where Missouri sits
The same service costs 2.7 times more in Oklahoma than in West Virginia. 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· 14th of 51
$63.10
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.