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 $154.88 Median $190.55 Typical High $223.87 | Facility | None | $154.88 | $190.55 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $190.55 | Professional | None | $154.88 | $154.88 | $190.55 |
Anthem BCBS Setting Facility Modifier None Typical Low $158.49 Median $213.80 Typical High $416.87 | Facility | None | $158.49 | $213.80 | $416.87 |
Anthem BCBS Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $190.55 | Professional | None | $144.54 | $190.55 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $269.15 Typical High $302.00 | Facility | None | $186.21 | $269.15 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Medica Setting Facility Modifier None Typical Low $48.98 Median $173.78 Typical High $676.08 | Facility | None | $48.98 | $173.78 | $676.08 |
Medica Setting Professional Modifier None Typical Low $141.25 Median $154.88 Typical High $165.96 | Professional | None | $141.25 | $154.88 | $165.96 |
United Setting Professional Modifier None Typical Low $131.83 Median $158.49 Typical High $181.97 | Professional | None | $131.83 | $158.49 | $181.97 |
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 $77.62 Median $77.62 Typical High $95.50 | Professional | 52 · Reduced service | $77.62 | $77.62 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $38.02 | Professional | 53 · Discontinued | $30.90 | $30.90 | $38.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $22.91 Typical High $28.84 | Professional | 55 · Aftercare only | $22.91 | $22.91 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $19.05 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $19.05 |
Where Missouri sits
The same service costs 4.4 times more in Alaska 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· 27th of 51
$158
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.