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 $26.92 Median $33.88 Typical High $46.77 | Facility | None | $26.92 | $33.88 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $33.88 | Professional | None | $26.92 | $26.92 | $33.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.02 Median $0.02 Typical High $0.03 | Facility | None | $0.02 | $0.02 | $0.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $25.70 Median $33.88 Typical High $33.88 | Professional | None | $25.70 | $33.88 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $47.86 Typical High $53.70 | Facility | None | $32.36 | $47.86 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Professional | None | $28.84 | $28.84 | $28.84 |
Medica Setting Facility Modifier None Typical Low $26.92 Median $75.86 Typical High $151.36 | Facility | None | $26.92 | $75.86 | $151.36 |
Medica Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $33.11 | Professional | None | $28.18 | $28.18 | $33.11 |
United Setting Professional Modifier None Typical Low $26.92 Median $33.88 Typical High $38.90 | Professional | None | $26.92 | $33.88 | $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 $13.49 Median $13.49 Typical High $16.98 | Professional | 52 · Reduced service | $13.49 | $13.49 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $5.50 Typical High $6.76 | Professional | 53 · Discontinued | $5.50 | $5.50 | $6.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.07 Median $4.07 Typical High $5.13 | Professional | 55 · Aftercare only | $4.07 | $4.07 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $2.69 Typical High $3.39 | Professional | 56 · Pre-op care only | $2.69 | $2.69 | $3.39 |
Where Missouri sits
The same service costs 1.7 times more in Arizona than in Oklahoma. 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· 27th of 51
$32.36
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.