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 $524.81 Median $575.44 Typical High $812.83 | Facility | None | $524.81 | $575.44 | $812.83 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $616.60 | Professional | None | $512.86 | $512.86 | $616.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $524.81 Median $691.83 Typical High $1,737.80 | Facility | None | $524.81 | $691.83 | $1,737.80 |
Anthem BCBS Setting Professional Modifier None Typical Low $501.19 Median $549.54 Typical High $575.44 | Professional | None | $501.19 | $549.54 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $870.96 Typical High $1,202.26 | Facility | None | $575.44 | $870.96 | $1,202.26 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Professional | None | $512.86 | $512.86 | $512.86 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $575.44 Typical High $2,398.83 | Facility | None | $478.63 | $575.44 | $2,398.83 |
Medica Setting Professional Modifier None Typical Low $446.68 Median $489.78 Typical High $549.54 | Professional | None | $446.68 | $489.78 | $549.54 |
United Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
United Setting Professional Modifier None Typical Low $467.74 Median $501.19 Typical High $562.34 | Professional | None | $467.74 | $501.19 | $562.34 |
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 $257.04 Median $257.04 Typical High $309.03 | Professional | 52 · Reduced service | $257.04 | $257.04 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $123.03 | Professional | 53 · Discontinued | $102.33 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $75.86 Typical High $91.20 | Professional | 55 · Aftercare only | $75.86 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $61.66 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $61.66 |
Where Missouri sits
The same service costs 2.8 times more in Arizona 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· 38th of 51
$513
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.