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 $331.13 Median $371.54 Typical High $512.86 | Facility | None | $331.13 | $371.54 | $512.86 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $380.19 | Professional | None | $316.23 | $316.23 | $380.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $331.13 Median $426.58 Typical High $1,096.48 | Facility | None | $331.13 | $426.58 | $1,096.48 |
Anthem BCBS Setting Professional Modifier None Typical Low $309.03 Median $346.74 Typical High $371.54 | Professional | None | $309.03 | $346.74 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $389.05 Typical High $933.25 | Facility | None | $363.08 | $389.05 | $933.25 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Professional | None | $316.23 | $316.23 | $316.23 |
Medica Setting Facility Modifier None Typical Low $288.40 Median $346.74 Typical High $1,479.11 | Facility | None | $288.40 | $346.74 | $1,479.11 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $354.81 | Professional | None | $275.42 | $309.03 | $354.81 |
United Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
United Setting Professional Modifier None Typical Low $295.12 Median $309.03 Typical High $354.81 | Professional | None | $295.12 | $309.03 | $354.81 |
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 $158.49 Median $158.49 Typical High $190.55 | Professional | 52 · Reduced service | $158.49 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $64.57 Typical High $75.86 | Professional | 53 · Discontinued | $64.57 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $47.86 Typical High $57.54 | Professional | 55 · Aftercare only | $47.86 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $31.62 Typical High $38.02 | Professional | 56 · Pre-op care only | $31.62 | $31.62 | $38.02 |
Where Missouri sits
The same service costs 1.6 times more in Arizona than in Rhode Island. 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
$316
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.