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 $53.70 Median $53.70 Typical High $54.95 | Facility | None | $53.70 | $53.70 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $53.70 Typical High $54.95 | Professional | None | $34.67 | $53.70 | $54.95 |
Anthem BCBS Setting Professional Modifier None Typical Low $60.26 Median $147.91 Typical High $147.91 | Professional | None | $60.26 | $147.91 | $147.91 |
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 $52.48 Median $147.91 Typical High $331.13 | Facility | None | $52.48 | $147.91 | $331.13 |
Medica Setting Professional Modifier None Typical Low $60.26 Median $371.54 Typical High $371.54 | Professional | None | $60.26 | $371.54 | $371.54 |
United Setting Professional Modifier None Typical Low $60.26 Median $61.66 Typical High $61.66 | Professional | None | $60.26 | $61.66 | $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 $17.38 Median $26.92 Typical High $27.54 | Professional | 52 · Reduced service | $17.38 | $26.92 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $10.72 Typical High $11.22 | Professional | 53 · Discontinued | $6.92 | $10.72 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $8.13 Typical High $8.32 | Professional | 55 · Aftercare only | $5.25 | $8.13 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $5.37 Typical High $5.50 | Professional | 56 · Pre-op care only | $3.47 | $5.37 | $5.50 |
Where Missouri sits
The same service costs 4.6 times more in New York than in North Carolina. 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· 21st 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.