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 $40.74 Median $56.23 Typical High $79.43 | Facility | None | $40.74 | $56.23 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $56.23 | Professional | None | $42.66 | $42.66 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $42.66 Median $57.54 Typical High $141.25 | Facility | None | $42.66 | $57.54 | $141.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $40.74 Median $44.67 Typical High $56.23 | Professional | None | $40.74 | $44.67 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $74.13 Typical High $100.00 | Facility | None | $48.98 | $74.13 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
Medica Setting Facility Modifier None Typical Low $40.74 Median $53.70 Typical High $204.17 | Facility | None | $40.74 | $53.70 | $204.17 |
Medica Setting Professional Modifier None Typical Low $37.15 Median $40.74 Typical High $47.86 | Professional | None | $37.15 | $40.74 | $47.86 |
United Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
United Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $46.77 | Professional | None | $40.74 | $40.74 | $46.77 |
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 $21.38 Median $21.38 Typical High $28.18 | Professional | 52 · Reduced service | $21.38 | $21.38 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $11.22 | Professional | 53 · Discontinued | $8.51 | $8.51 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $8.51 | Professional | 55 · Aftercare only | $6.46 | $6.46 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $5.62 | Professional | 56 · Pre-op care only | $4.27 | $4.27 | $5.62 |
Where Missouri sits
The same service costs 1.7 times more in Arizona than in Maryland. 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· 42nd of 51
$42.66
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.