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 $46.77 Median $97.72 Typical High $138.04 | Facility | None | $46.77 | $97.72 | $138.04 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $97.72 | Professional | None | $77.62 | $77.62 | $97.72 |
Anthem BCBS Setting Facility Modifier None Typical Low $63.10 Median $89.13 Typical High $204.17 | Facility | None | $63.10 | $89.13 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $77.62 Typical High $97.72 | Professional | None | $46.77 | $77.62 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $134.90 Typical High $181.97 | Facility | None | $89.13 | $134.90 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Medica Setting Facility Modifier None Typical Low $47.86 Median $97.72 Typical High $426.58 | Facility | None | $47.86 | $97.72 | $426.58 |
Medica Setting Professional Modifier None Typical Low $32.36 Median $40.74 Typical High $46.77 | Professional | None | $32.36 | $40.74 | $46.77 |
United Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $58.88 | Professional | None | $46.77 | $46.77 | $58.88 |
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 $38.90 Median $38.90 Typical High $48.98 | Professional | 52 · Reduced service | $38.90 | $38.90 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $19.50 | Professional | 53 · Discontinued | $15.49 | $15.49 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $14.79 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $9.77 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $9.77 |
Where Missouri sits
The same service costs 3.6 times more in Texas than in Kansas. 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· 35th of 51
$77.62
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.