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 $380.19 Median $398.11 Typical High $549.54 | Facility | None | $380.19 | $398.11 | $549.54 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $501.19 | Professional | None | $389.05 | $389.05 | $501.19 |
Anthem BCBS Setting Facility Modifier None Typical Low $398.11 Median $524.81 Typical High $1,348.96 | Facility | None | $398.11 | $524.81 | $1,348.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $416.87 Typical High $446.68 | Professional | None | $380.19 | $416.87 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $851.14 Typical High $1,000.00 | Facility | None | $489.78 | $851.14 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Medica Setting Facility Modifier None Typical Low $363.08 Median $426.58 Typical High $1,862.09 | Facility | None | $363.08 | $426.58 | $1,862.09 |
Medica Setting Professional Modifier None Typical Low $371.54 Median $380.19 Typical High $446.68 | Professional | None | $371.54 | $380.19 | $446.68 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
United Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $457.09 | Professional | None | $380.19 | $380.19 | $457.09 |
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 $194.98 Median $194.98 Typical High $234.42 | Professional | 52 · Reduced service | $194.98 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $93.33 | Professional | 53 · Discontinued | $77.62 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $57.54 Typical High $69.18 | Professional | 55 · Aftercare only | $57.54 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $46.77 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $46.77 |
Where Missouri sits
The same service costs 11.5 times more in Alabama 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· 29th of 51
$398
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.