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 $380.19 Median $446.68 Typical High $616.60 | Facility | None | $380.19 | $446.68 | $616.60 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $467.74 | Professional | None | $389.05 | $389.05 | $467.74 |
Anthem BCBS Setting Facility Modifier None Typical Low $407.38 Median $524.81 Typical High $1,348.96 | Facility | None | $407.38 | $524.81 | $1,348.96 |
Anthem BCBS Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $446.68 | Professional | None | $380.19 | $426.58 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $478.63 Typical High $1,148.15 | Facility | None | $446.68 | $478.63 | $1,148.15 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $457.09 Typical High $2,187.76 | Facility | None | $380.19 | $457.09 | $2,187.76 |
Medica Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $446.68 | Professional | None | $380.19 | $380.19 | $446.68 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
United Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $457.09 | Professional | None | $380.19 | $380.19 | $457.09 |
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 $194.98 Median $194.98 Typical High $234.42 | Professional | 52 · Reduced service | $194.98 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $79.43 Typical High $93.33 | Professional | 53 · Discontinued | $79.43 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $70.79 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $46.77 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $46.77 |
Where Missouri sits
The same service costs 1.9 times more in Texas than in Illinois. 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
$407
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.