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 $91.20 Median $102.33 Typical High $177.83 | Facility | None | $91.20 | $102.33 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $173.78 Typical High $177.83 | Professional | None | $102.33 | $173.78 | $177.83 |
Anthem BCBS Setting Facility Modifier None Typical Low $123.03 Median $199.53 Typical High $457.09 | Facility | None | $123.03 | $199.53 | $457.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $173.78 Typical High $234.42 | Professional | None | $91.20 | $173.78 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $295.12 Typical High $407.38 | Facility | None | $199.53 | $295.12 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Professional | None | $173.78 | $173.78 | $173.78 |
Medica Setting Facility Modifier None Typical Low $79.43 Median $102.33 Typical High $380.19 | Facility | None | $79.43 | $102.33 | $380.19 |
Medica Setting Professional Modifier None Typical Low $66.07 Median $75.86 Typical High $87.10 | Professional | None | $66.07 | $75.86 | $87.10 |
United Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $114.82 | Professional | None | $91.20 | $91.20 | $114.82 |
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 $51.29 Median $87.10 Typical High $89.13 | Professional | 52 · Reduced service | $51.29 | $87.10 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $34.67 Typical High $35.48 | Professional | 53 · Discontinued | $20.42 | $34.67 | $35.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $25.70 Typical High $26.92 | Professional | 55 · Aftercare only | $15.14 | $25.70 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $17.38 Typical High $17.78 | Professional | 56 · Pre-op care only | $10.23 | $17.38 | $17.78 |
Where Missouri sits
The same service costs 3.2 times more in Wyoming 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· 30th of 51
$155
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.