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 $21.88 Median $31.62 Typical High $60.26 | Facility | None | $21.88 | $31.62 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $21.88 Typical High $43.65 | Professional | None | $20.89 | $21.88 | $43.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $22.91 Median $29.51 Typical High $77.62 | Facility | None | $22.91 | $29.51 | $77.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.89 Median $23.99 Typical High $45.71 | Professional | None | $20.89 | $23.99 | $45.71 |
Cigna Setting Facility Modifier None Typical Low $23.99 Median $37.15 Typical High $50.12 | Facility | None | $23.99 | $37.15 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
Medica Setting Facility Modifier None Typical Low $19.05 Median $36.31 Typical High $104.71 | Facility | None | $19.05 | $36.31 | $104.71 |
Medica Setting Professional Modifier None Typical Low $17.78 Median $19.05 Typical High $21.88 | Professional | None | $17.78 | $19.05 | $21.88 |
United Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
United Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $27.54 | Professional | None | $21.88 | $21.88 | $27.54 |
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 $10.47 Median $10.47 Typical High $21.88 | Professional | 52 · Reduced service | $10.47 | $10.47 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $4.27 Typical High $8.71 | Professional | 53 · Discontinued | $4.27 | $4.27 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $6.61 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.09 Typical High $4.37 | Professional | 56 · Pre-op care only | $2.09 | $2.09 | $4.37 |
Where Missouri sits
The same service costs 2.6 times more in Wyoming than in Texas. 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· 29th of 51
$21.88
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.