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 $30.90 Median $31.62 Typical High $194.98 | Facility | None | $30.90 | $31.62 | $194.98 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $37.15 | Professional | None | $30.90 | $30.90 | $37.15 |
Anthem BCBS Setting Facility Modifier None Typical Low $30.20 Median $41.69 Typical High $97.72 | Facility | None | $30.20 | $41.69 | $97.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.18 Median $30.90 Typical High $60.26 | Professional | None | $28.18 | $30.90 | $60.26 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $52.48 Typical High $70.79 | Facility | None | $35.48 | $52.48 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Medica Setting Facility Modifier None Typical Low $20.89 Median $60.26 Typical High $257.04 | Facility | None | $20.89 | $60.26 | $257.04 |
Medica Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $43.65 | Professional | None | $36.31 | $36.31 | $43.65 |
United Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
United Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $47.86 | Professional | None | $36.31 | $36.31 | $47.86 |
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 $15.49 Median $15.49 Typical High $18.62 | Professional | 52 · Reduced service | $15.49 | $15.49 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $7.41 | Professional | 53 · Discontinued | $6.17 | $6.17 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $5.50 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $3.72 |
Where Missouri sits
The same service costs 1.9 times more in Texas than in Tennessee. 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· 7th of 51
$36.31
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.