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 $213.80 Median $602.56 Typical High $831.76 | Facility | None | $213.80 | $602.56 | $831.76 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $602.56 | Professional | None | $295.12 | $295.12 | $602.56 |
Anthem BCBS Setting Facility Modifier None Typical Low $229.09 Median $363.08 Typical High $776.25 | Facility | None | $229.09 | $363.08 | $776.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $295.12 Typical High $537.03 | Professional | None | $213.80 | $295.12 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $512.86 Typical High $691.83 | Facility | None | $338.84 | $512.86 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Professional | None | $295.12 | $295.12 | $295.12 |
Medica Setting Facility Modifier None Typical Low $194.98 Median $416.87 Typical High $2,187.76 | Facility | None | $194.98 | $416.87 | $2,187.76 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $281.84 | Professional | None | $194.98 | $194.98 | $281.84 |
United Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
United Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $269.15 | Professional | None | $213.80 | $213.80 | $269.15 |
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 $147.91 Median $147.91 Typical High $302.00 | Professional | 52 · Reduced service | $147.91 | $147.91 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $120.23 | Professional | 53 · Discontinued | $58.88 | $58.88 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $89.13 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $60.26 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $60.26 |
Where Missouri sits
The same service costs 6.8 times more in Wyoming 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· 27th of 51
$295
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.