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 $56.23 Median $72.44 Typical High $91.20 | Facility | None | $56.23 | $72.44 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $72.44 Typical High $72.44 | Professional | None | $66.07 | $72.44 | $72.44 |
Anthem BCBS Setting Facility Modifier None Typical Low $75.86 Median $102.33 Typical High $199.53 | Facility | None | $75.86 | $102.33 | $199.53 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $91.20 Typical High $91.20 | Professional | None | $67.61 | $91.20 | $91.20 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $125.89 Typical High $144.54 | Facility | None | $87.10 | $125.89 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $66.07 Typical High $275.42 | Facility | None | $54.95 | $66.07 | $275.42 |
Medica Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $87.10 | Professional | None | $72.44 | $72.44 | $87.10 |
United Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $93.33 | Professional | None | $75.86 | $75.86 | $93.33 |
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 $33.11 Median $36.31 Typical High $36.31 | Professional | 52 · Reduced service | $33.11 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $13.18 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.96 Typical High $10.96 | Professional | 55 · Aftercare only | $10.00 | $10.96 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $6.61 | $7.24 | $7.24 |
Where Missouri sits
The same service costs 25.1 times more in Alabama than in Nebraska. 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· 24th of 51
$75.86
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.