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 $18.62 Median $29.51 Typical High $53.70 | Facility | None | $18.62 | $29.51 | $53.70 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $38.02 | Professional | None | $18.20 | $18.20 | $38.02 |
Anthem BCBS Setting Facility Modifier None Typical Low $19.50 Median $26.30 Typical High $67.61 | Facility | None | $19.50 | $26.30 | $67.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.20 Median $21.38 Typical High $38.02 | Professional | None | $18.20 | $21.38 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $22.91 Median $39.81 Typical High $46.77 | Facility | None | $22.91 | $39.81 | $46.77 |
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 $16.22 Median $38.02 Typical High $134.90 | Facility | None | $16.22 | $38.02 | $134.90 |
Medica Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $21.88 | Professional | None | $17.38 | $17.38 | $21.88 |
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 $19.50 Median $19.50 Typical High $30.90 | Professional | None | $19.50 | $19.50 | $30.90 |
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 $9.12 Median $9.12 Typical High $19.05 | Professional | 52 · Reduced service | $9.12 | $9.12 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $7.76 | Professional | 53 · Discontinued | $3.63 | $3.63 | $7.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $2.69 Typical High $5.75 | Professional | 55 · Aftercare only | $2.69 | $2.69 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $1.82 Typical High $3.80 | Professional | 56 · Pre-op care only | $1.82 | $1.82 | $3.80 |
Where Missouri sits
The same service costs 2.1 times more in Oklahoma than in Florida. 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
$19.50
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.