How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $44.67 Median $56.23 Typical High $67.61 | Facility | None | $44.67 | $56.23 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $56.23 | Professional | None | $44.67 | $44.67 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $46.77 Median $63.10 Typical High $123.03 | Facility | None | $46.77 | $63.10 | $123.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $41.69 Median $56.23 Typical High $56.23 | Professional | None | $41.69 | $56.23 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $79.43 Typical High $89.13 | Facility | None | $53.70 | $79.43 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Medica Setting Facility Modifier None Typical Low $67.61 Median $117.49 Typical High $416.87 | Facility | None | $67.61 | $117.49 | $416.87 |
Medica Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $125.89 | Professional | None | $69.18 | $69.18 | $125.89 |
United Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $57.54 | Professional | None | $46.77 | $46.77 | $57.54 |
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 $22.39 Median $22.39 Typical High $28.18 | Professional | 52 · Reduced service | $22.39 | $22.39 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $11.22 | Professional | 53 · Discontinued | $8.91 | $8.91 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $8.32 | Professional | 55 · Aftercare only | $6.76 | $6.76 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.47 Typical High $5.62 | Professional | 56 · Pre-op care only | $4.47 | $4.47 | $5.62 |
Where Missouri sits
The same service costs 3.9 times more in Hawaii than in South Carolina. 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· 24th of 51
$53.70
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.