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 $18.20 Median $25.12 Typical High $34.67 | Facility | None | $18.20 | $25.12 | $34.67 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $25.12 | Professional | None | $18.20 | $18.20 | $25.12 |
Anthem BCBS Setting Facility Modifier None Typical Low $18.20 Median $24.55 Typical High $63.10 | Facility | None | $18.20 | $24.55 | $63.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.20 Median $19.95 Typical High $25.12 | Professional | None | $18.20 | $19.95 | $25.12 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $30.90 Typical High $42.66 | Facility | None | $20.89 | $30.90 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Professional | None | $18.20 | $18.20 | $18.20 |
Medica Setting Facility Modifier None Typical Low $17.38 Median $35.48 Typical High $263.03 | Facility | None | $17.38 | $35.48 | $263.03 |
Medica Setting Professional Modifier None Typical Low $15.85 Median $17.38 Typical High $19.95 | Professional | None | $15.85 | $17.38 | $19.95 |
United Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
United Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $22.39 | Professional | None | $18.20 | $18.20 | $22.39 |
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 $9.12 Median $9.12 Typical High $12.59 | Professional | 52 · Reduced service | $9.12 | $9.12 | $12.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $5.01 | Professional | 53 · Discontinued | $3.63 | $3.63 | $5.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.69 Typical High $3.72 | Professional | 55 · Aftercare only | $2.69 | $2.69 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $2.51 | Professional | 56 · Pre-op care only | $1.82 | $1.82 | $2.51 |
Where Missouri sits
The same service costs 28.8 times more in Alabama than in Washington, DC. 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· 43rd of 51
$18.20
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.