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 $13.80 Median $16.60 Typical High $120.23 | Facility | None | $13.80 | $16.60 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $22.39 | Professional | None | $16.22 | $16.22 | $22.39 |
Anthem BCBS Setting Facility Modifier None Typical Low $14.79 Median $21.88 Typical High $47.86 | Facility | None | $14.79 | $21.88 | $47.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $13.80 Median $16.22 Typical High $85.11 | Professional | None | $13.80 | $16.22 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $19.50 Median $26.30 Typical High $41.69 | Facility | None | $19.50 | $26.30 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
Medica Setting Facility Modifier None Typical Low $22.91 Median $28.18 Typical High $85.11 | Facility | None | $22.91 | $28.18 | $85.11 |
Medica Setting Professional Modifier None Typical Low $25.12 Median $26.30 Typical High $33.11 | Professional | None | $25.12 | $26.30 | $33.11 |
United Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
United Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $25.12 | Professional | None | $13.80 | $13.80 | $25.12 |
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 $8.13 Median $8.13 Typical High $9.77 | Professional | 52 · Reduced service | $8.13 | $8.13 | $9.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.24 Typical High $3.89 | Professional | 53 · Discontinued | $3.24 | $3.24 | $3.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $2.40 Typical High $2.88 | Professional | 55 · Aftercare only | $2.40 | $2.40 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $1.95 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $1.95 |
Where Missouri sits
The same service costs 5.9 times more in Wyoming than in North Dakota. 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· 23rd of 51
$16.98
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.