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 $17.38 Median $29.51 Typical High $40.74 | Facility | None | $17.38 | $29.51 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $29.51 | Professional | None | $18.20 | $18.20 | $29.51 |
Anthem BCBS Setting Facility Modifier None Typical Low $18.62 Median $24.55 Typical High $61.66 | Facility | None | $18.62 | $24.55 | $61.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.38 Median $19.50 Typical High $29.51 | Professional | None | $17.38 | $19.50 | $29.51 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $30.90 Typical High $42.66 | Facility | None | $20.89 | $30.90 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Medica Setting Facility Modifier None Typical Low $15.85 Median $25.70 Typical High $85.11 | Facility | None | $15.85 | $25.70 | $85.11 |
Medica Setting Professional Modifier None Typical Low $16.60 Median $17.78 Typical High $20.42 | Professional | None | $16.60 | $17.78 | $20.42 |
United Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
United Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $23.44 | Professional | None | $17.38 | $17.38 | $23.44 |
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 $9.12 Median $9.12 Typical High $14.79 | Professional | 52 · Reduced service | $9.12 | $9.12 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $5.89 | Professional | 53 · Discontinued | $3.63 | $3.63 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.69 Typical High $4.37 | Professional | 55 · Aftercare only | $2.69 | $2.69 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $2.95 | Professional | 56 · Pre-op care only | $1.82 | $1.82 | $2.95 |
Where Missouri sits
The same service costs 1.9 times more in Alaska than in Mississippi. 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
$18.62
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.