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 $18.62 Median $26.30 Typical High $44.67 | Facility | None | $18.62 | $26.30 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $36.31 | Professional | None | $19.50 | $19.50 | $36.31 |
Anthem BCBS Setting Facility Modifier None Typical Low $19.50 Median $26.30 Typical High $64.57 | Facility | None | $19.50 | $26.30 | $64.57 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.62 Median $20.42 Typical High $26.30 | Professional | None | $18.62 | $20.42 | $26.30 |
Cigna Setting Facility Modifier None Typical Low $22.39 Median $33.11 Typical High $45.71 | Facility | None | $22.39 | $33.11 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | None | $19.50 | $19.50 | $19.50 |
Medica Setting Facility Modifier None Typical Low $17.38 Median $23.99 Typical High $91.20 | Facility | None | $17.38 | $23.99 | $91.20 |
Medica Setting Professional Modifier None Typical Low $16.60 Median $18.20 Typical High $20.89 | Professional | None | $16.60 | $18.20 | $20.89 |
United Setting Facility Modifier None Typical Low $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
United Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $21.38 | Professional | None | $18.62 | $18.62 | $21.38 |
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 $9.55 Median $9.55 Typical High $13.18 | Professional | 52 · Reduced service | $9.55 | $9.55 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $3.89 Typical High $5.25 | Professional | 53 · Discontinued | $3.89 | $3.89 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.88 Median $2.88 Typical High $3.98 | Professional | 55 · Aftercare only | $2.88 | $2.88 | $3.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $1.95 Typical High $2.63 | Professional | 56 · Pre-op care only | $1.95 | $1.95 | $2.63 |
Where Missouri sits
The same service costs 1.9 times more in Alaska than in Rhode Island. 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· 24th of 51
$19.50
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.