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 $524.81 Median $1,202.26 Typical High $1,659.59 | Facility | None | $524.81 | $1,202.26 | $1,659.59 |
Aetna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $1,380.38 | Professional | None | $537.03 | $537.03 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $549.54 Median $724.44 Typical High $1,862.09 | Facility | None | $549.54 | $724.44 | $1,862.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $524.81 Median $575.44 Typical High $1,380.38 | Professional | None | $524.81 | $575.44 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $933.25 Typical High $1,380.38 | Facility | None | $616.60 | $933.25 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
Medica Setting Facility Modifier None Typical Low $524.81 Median $630.96 Typical High $1,202.26 | Facility | None | $524.81 | $630.96 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $524.81 Typical High $602.56 | Professional | None | $478.63 | $524.81 | $602.56 |
United Setting Facility Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Facility | None | $537.03 | $537.03 | $537.03 |
United Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $660.69 | Professional | None | $524.81 | $524.81 | $660.69 |
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 $269.15 Median $269.15 Typical High $691.83 | Professional | 52 · Reduced service | $269.15 | $269.15 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $107.15 Typical High $275.42 | Professional | 53 · Discontinued | $107.15 | $107.15 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $79.43 Typical High $208.93 | Professional | 55 · Aftercare only | $79.43 | $79.43 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $138.04 | Professional | 56 · Pre-op care only | $53.70 | $53.70 | $138.04 |
Where Missouri sits
The same service costs 5.0 times more in Wyoming than in Alabama. 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· 38th of 51
$537
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.