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 $83.18 Median $104.71 Typical High $144.54 | Facility | None | $83.18 | $104.71 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $104.71 | Professional | None | $83.18 | $83.18 | $104.71 |
Anthem BCBS Setting Facility Modifier None Typical Low $87.10 Median $117.49 Typical High $229.09 | Facility | None | $87.10 | $117.49 | $229.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $104.71 Typical High $104.71 | Professional | None | $77.62 | $104.71 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $144.54 Typical High $165.96 | Facility | None | $100.00 | $144.54 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
Medica Setting Facility Modifier None Typical Low $83.18 Median $112.20 Typical High $436.52 | Facility | None | $83.18 | $112.20 | $436.52 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $100.00 | Professional | None | $87.10 | $87.10 | $100.00 |
United Setting Professional Modifier None Typical Low $83.18 Median $87.10 Typical High $100.00 | Professional | None | $83.18 | $87.10 | $100.00 |
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 $41.69 Median $41.69 Typical High $52.48 | Professional | 52 · Reduced service | $41.69 | $41.69 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $16.60 Typical High $20.89 | Professional | 53 · Discontinued | $16.60 | $16.60 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $15.49 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.32 Typical High $10.47 | Professional | 56 · Pre-op care only | $8.32 | $8.32 | $10.47 |
Where Missouri sits
The same service costs 1.6 times more in Alaska than in Texas. 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· 45th of 51
$87.10
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.