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 $31.62 Median $67.61 Typical High $93.33 | Facility | None | $31.62 | $67.61 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $67.61 | Professional | None | $31.62 | $31.62 | $67.61 |
Anthem BCBS Setting Facility Modifier None Typical Low $31.62 Median $42.66 Typical High $83.18 | Facility | None | $31.62 | $42.66 | $83.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $31.62 Median $34.67 Typical High $67.61 | Professional | None | $31.62 | $34.67 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $54.95 Typical High $74.13 | Facility | None | $36.31 | $54.95 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Professional | None | $31.62 | $31.62 | $31.62 |
Medica Setting Facility Modifier None Typical Low $21.38 Median $75.86 Typical High $251.19 | Facility | None | $21.38 | $75.86 | $251.19 |
Medica Setting Professional Modifier None Typical Low $28.84 Median $31.62 Typical High $36.31 | Professional | None | $28.84 | $31.62 | $36.31 |
United Setting Professional Modifier None Typical Low $31.62 Median $31.62 Typical High $38.90 | Professional | None | $31.62 | $31.62 | $38.90 |
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 $15.85 Median $15.85 Typical High $33.11 | Professional | 52 · Reduced service | $15.85 | $15.85 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $6.31 Typical High $13.49 | Professional | 53 · Discontinued | $6.31 | $6.31 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $10.00 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $3.16 Typical High $6.76 | Professional | 56 · Pre-op care only | $3.16 | $3.16 | $6.76 |
Where Missouri sits
The same service costs 3.8 times more in Alabama than in Virginia. 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· 39th of 51
$31.62
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.