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 $57.54 Median $63.10 Typical High $234.42 | Facility | None | $57.54 | $63.10 | $234.42 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $72.44 | Professional | None | $57.54 | $57.54 | $72.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $60.26 Median $81.28 Typical High $158.49 | Facility | None | $60.26 | $81.28 | $158.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $72.44 Typical High $72.44 | Professional | None | $53.70 | $72.44 | $72.44 |
BCBS Setting Professional Modifier None Typical Low $69.18 Median $70.79 Typical High $109.65 | Professional | None | $69.18 | $70.79 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $102.33 Typical High $114.82 | Facility | None | $69.18 | $102.33 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
Medica Setting Facility Modifier None Typical Low $60.26 Median $102.33 Typical High $269.15 | Facility | None | $60.26 | $102.33 | $269.15 |
Medica Setting Professional Modifier None Typical Low $60.26 Median $478.63 Typical High $478.63 | Professional | None | $60.26 | $478.63 | $478.63 |
United Setting Professional Modifier None Typical Low $53.70 Median $60.26 Typical High $61.66 | Professional | None | $53.70 | $60.26 | $61.66 |
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 $28.84 Median $28.84 Typical High $36.31 | Professional | 52 · Reduced service | $28.84 | $28.84 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $14.45 | Professional | 53 · Discontinued | $11.48 | $11.48 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $10.96 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $7.24 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $7.24 |
Where Missouri sits
The same service costs 1.6 times more in Alaska than in Hawaii. 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· 25th of 51
$61.66
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.