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 $35.48 Median $56.23 Typical High $66.07 | Facility | None | $35.48 | $56.23 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $56.23 | Professional | None | $35.48 | $35.48 | $56.23 |
Anthem BCBS Setting Facility Modifier None Typical Low $36.31 Median $48.98 Typical High $95.50 | Facility | None | $36.31 | $48.98 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $33.11 Median $43.65 Typical High $43.65 | Professional | None | $33.11 | $43.65 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $61.66 Typical High $69.18 | Facility | None | $42.66 | $61.66 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Medica Setting Facility Modifier None Typical Low $47.86 Median $75.86 Typical High $229.09 | Facility | None | $47.86 | $75.86 | $229.09 |
Medica Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $53.70 | Professional | None | $42.66 | $46.77 | $53.70 |
United Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $45.71 | Professional | None | $36.31 | $36.31 | $45.71 |
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 $17.38 Median $17.38 Typical High $27.54 | Professional | 52 · Reduced service | $17.38 | $17.38 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $7.08 Typical High $11.22 | Professional | 53 · Discontinued | $7.08 | $7.08 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $5.25 Typical High $8.32 | Professional | 55 · Aftercare only | $5.25 | $5.25 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.55 Typical High $5.62 | Professional | 56 · Pre-op care only | $3.55 | $3.55 | $5.62 |
Where Missouri sits
The same service costs 8.1 times more in Kansas 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· 13th of 51
$41.69
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.