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 $46.77 Median $46.77 Typical High $70.79 | Facility | None | $46.77 | $46.77 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Professional | None | $46.77 | $46.77 | $46.77 |
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 $44.67 Median $58.88 Typical High $58.88 | Professional | None | $44.67 | $58.88 | $58.88 |
BCBS Kansas City Setting Professional Modifier None Typical Low $56.23 Median $57.54 Typical High $89.13 | Professional | None | $56.23 | $57.54 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $123.03 Typical High $134.90 | Facility | None | $64.57 | $123.03 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Medica Setting Facility Modifier None Typical Low $46.77 Median $100.00 Typical High $263.03 | Facility | None | $46.77 | $100.00 | $263.03 |
Medica Setting Professional Modifier None Typical Low $52.48 Median $61.66 Typical High $69.18 | Professional | None | $52.48 | $61.66 | $69.18 |
United Setting Professional Modifier None Typical Low $52.48 Median $58.88 Typical High $67.61 | Professional | None | $52.48 | $58.88 | $67.61 |
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 $23.44 Median $23.44 Typical High $23.44 | Professional | 52 · Reduced service | $23.44 | $23.44 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $9.33 Typical High $9.33 | Professional | 53 · Discontinued | $9.33 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.08 Typical High $7.08 | Professional | 55 · Aftercare only | $7.08 | $7.08 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $4.68 Typical High $4.68 | Professional | 56 · Pre-op care only | $4.68 | $4.68 | $4.68 |
Where Missouri sits
The same service costs 1.6 times more in Alaska than in Pennsylvania. 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· 15th of 51
$56.23
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.