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 $67.61 Median $87.10 Typical High $288.40 | Facility | None | $67.61 | $87.10 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $100.00 | Professional | None | $67.61 | $67.61 | $100.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $72.44 Median $107.15 Typical High $275.42 | Facility | None | $72.44 | $107.15 | $275.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $67.61 Median $87.10 Typical High $208.93 | Professional | None | $67.61 | $87.10 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $85.11 Median $141.25 Typical High $173.78 | Facility | None | $85.11 | $141.25 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
Medica Setting Facility Modifier None Typical Low $97.72 Median $117.49 Typical High $416.87 | Facility | None | $97.72 | $117.49 | $416.87 |
Medica Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $128.82 | Professional | None | $104.71 | $104.71 | $128.82 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
United Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $147.91 | Professional | None | $79.43 | $79.43 | $147.91 |
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 $33.88 Median $33.88 Typical High $39.81 | Professional | 52 · Reduced service | $33.88 | $33.88 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $16.22 | Professional | 53 · Discontinued | $13.49 | $13.49 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $12.02 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $7.94 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $7.94 |
Where Missouri sits
The same service costs 2.7 times more in South Carolina than in Georgia. 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· 15th of 51
$89.13
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.