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 $8.51 Median $19.50 Typical High $19.50 | Facility | None | $8.51 | $19.50 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $8.51 Median $12.02 Typical High $19.50 | Professional | None | $8.51 | $12.02 | $19.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.13 Median $11.22 Typical High $17.38 | Professional | None | $8.13 | $11.22 | $17.38 |
BCBS Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $19.95 | Professional | None | $12.02 | $12.02 | $19.95 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Medica Setting Facility Modifier None Typical Low $10.47 Median $39.81 Typical High $91.20 | Facility | None | $10.47 | $39.81 | $91.20 |
Medica Setting Professional Modifier None Typical Low $6.92 Median $9.77 Typical High $158.49 | Professional | None | $6.92 | $9.77 | $158.49 |
United Setting Professional Modifier None Typical Low $6.61 Median $9.77 Typical High $16.22 | Professional | None | $6.61 | $9.77 | $16.22 |
5 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 $4.27 Median $6.03 Typical High $9.77 | Professional | 52 · Reduced service | $4.27 | $6.03 | $9.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.70 Median $2.40 Typical High $3.89 | Professional | 53 · Discontinued | $1.70 | $2.40 | $3.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $6.31 Median $8.91 Typical High $14.79 | Professional | 54 · Surgery only | $6.31 | $8.91 | $14.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.26 Median $1.82 Typical High $2.95 | Professional | 55 · Aftercare only | $1.26 | $1.82 | $2.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.83 Median $1.20 Typical High $1.95 | Professional | 56 · Pre-op care only | $0.83 | $1.20 | $1.95 |
Where Missouri sits
The same service costs 2.8 times more in Hawaii than in New York. 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· 33rd of 51
$11.22
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.