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 $24.55 Median $42.66 Typical High $60.26 | Facility | None | $24.55 | $42.66 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $43.65 | Professional | None | $28.18 | $28.18 | $43.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $28.18 Median $38.02 Typical High $74.13 | Facility | None | $28.18 | $38.02 | $74.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $24.55 Median $28.18 Typical High $43.65 | Professional | None | $24.55 | $28.18 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $47.86 Typical High $66.07 | Facility | None | $32.36 | $47.86 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Professional | None | $28.18 | $28.18 | $28.18 |
Medica Setting Facility Modifier None Typical Low $23.99 Median $47.86 Typical High $100.00 | Facility | None | $23.99 | $47.86 | $100.00 |
Medica Setting Professional Modifier None Typical Low $16.22 Median $17.38 Typical High $19.95 | Professional | None | $16.22 | $17.38 | $19.95 |
United Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $30.20 | Professional | None | $24.55 | $24.55 | $30.20 |
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 $14.13 Median $14.13 Typical High $21.88 | Professional | 52 · Reduced service | $14.13 | $14.13 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $5.62 Typical High $8.71 | Professional | 53 · Discontinued | $5.62 | $5.62 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.27 Typical High $6.61 | Professional | 55 · Aftercare only | $4.27 | $4.27 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $4.37 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $4.37 |
Where Missouri sits
The same service costs 2.2 times more in Alaska 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· 26th of 51
$28.18
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.