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 $52.48 Median $69.18 Typical High $123.03 | Facility | None | $52.48 | $69.18 | $123.03 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $58.88 | Professional | None | $52.48 | $52.48 | $58.88 |
Anthem BCBS Setting Facility Modifier None Typical Low $52.48 Median $61.66 Typical High $186.21 | Facility | None | $52.48 | $61.66 | $186.21 |
Anthem BCBS Setting Professional Modifier None Typical Low $52.48 Median $56.23 Typical High $58.88 | Professional | None | $52.48 | $56.23 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $79.43 Typical High $89.13 | Facility | None | $53.70 | $79.43 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Medica Setting Facility Modifier None Typical Low $52.48 Median $79.43 Typical High $524.81 | Facility | None | $52.48 | $79.43 | $524.81 |
Medica Setting Professional Modifier None Typical Low $47.86 Median $52.48 Typical High $56.23 | Professional | None | $47.86 | $52.48 | $56.23 |
United Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
United Setting Professional Modifier None Typical Low $44.67 Median $52.48 Typical High $60.26 | Professional | None | $44.67 | $52.48 | $60.26 |
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 $26.30 Median $26.30 Typical High $29.51 | Professional | 52 · Reduced service | $26.30 | $26.30 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $12.02 | Professional | 53 · Discontinued | $10.72 | $10.72 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $8.91 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $5.89 |
Where Missouri sits
The same service costs 1.7 times more in Arizona than in Rhode Island. 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· 42nd of 51
$52.48
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.