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 $36.31 Median $44.67 Typical High $63.10 | Facility | None | $36.31 | $44.67 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $44.67 | Professional | None | $36.31 | $36.31 | $44.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $37.15 Median $50.12 Typical High $97.72 | Facility | None | $37.15 | $50.12 | $97.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.88 Median $44.67 Typical High $44.67 | Professional | None | $33.88 | $44.67 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $43.65 Median $63.10 Typical High $70.79 | Facility | None | $43.65 | $63.10 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | None | $38.02 | $38.02 | $38.02 |
Medica Setting Facility Modifier None Typical Low $1.10 Median $64.57 Typical High $169.82 | Facility | None | $1.10 | $64.57 | $169.82 |
Medica Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $43.65 | Professional | None | $37.15 | $37.15 | $43.65 |
United Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $42.66 | Professional | None | $37.15 | $37.15 | $42.66 |
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 $18.20 Median $18.20 Typical High $22.39 | Professional | 52 · Reduced service | $18.20 | $18.20 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $8.91 | Professional | 53 · Discontinued | $7.24 | $7.24 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $6.76 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $4.47 |
Where Missouri sits
The same service costs 20.4 times more in Arizona than in Hawaii. 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· 35th of 51
$37.15
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.