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 $446.68 Median $562.34 Typical High $776.25 | Facility | None | $446.68 | $562.34 | $776.25 |
Aetna Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $562.34 | Professional | None | $446.68 | $446.68 | $562.34 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.02 Median $0.02 Typical High $0.03 | Facility | None | $0.02 | $0.02 | $0.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $562.34 | Professional | None | $416.87 | $562.34 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $776.25 Typical High $891.25 | Facility | None | $537.03 | $776.25 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $478.63 | Professional | None | $478.63 | $478.63 | $478.63 |
Medica Setting Facility Modifier None Typical Low $4.27 Median $562.34 Typical High $2,290.87 | Facility | None | $4.27 | $562.34 | $2,290.87 |
Medica Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $537.03 | Professional | None | $467.74 | $467.74 | $537.03 |
United Setting Professional Modifier None Typical Low $446.68 Median $467.74 Typical High $537.03 | Professional | None | $446.68 | $467.74 | $537.03 |
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 $223.87 Median $223.87 Typical High $281.84 | Professional | 52 · Reduced service | $223.87 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $89.13 Typical High $112.20 | Professional | 53 · Discontinued | $89.13 | $89.13 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $67.61 Median $67.61 Typical High $83.18 | Professional | 55 · Aftercare only | $67.61 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $44.67 Typical High $56.23 | Professional | 56 · Pre-op care only | $44.67 | $44.67 | $56.23 |
Where Missouri sits
The same service costs 2.3 times more in Arizona than in Idaho. 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· 36th of 51
$468
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.