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 $138.04 Median $141.25 Typical High $1,288.25 | Facility | None | $138.04 | $141.25 | $1,288.25 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $204.17 | Professional | None | $138.04 | $138.04 | $204.17 |
Anthem BCBS Setting Facility Modifier None Typical Low $141.25 Median $186.21 Typical High $467.74 | Facility | None | $141.25 | $186.21 | $467.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $131.83 Median $147.91 Typical High $389.05 | Professional | None | $131.83 | $147.91 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $316.23 Typical High $389.05 | Facility | None | $173.78 | $316.23 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Medica Setting Facility Modifier None Typical Low $91.20 Median $389.05 Typical High $676.08 | Facility | None | $91.20 | $389.05 | $676.08 |
Medica Setting Professional Modifier None Typical Low $120.23 Median $131.83 Typical High $165.96 | Professional | None | $120.23 | $131.83 | $165.96 |
United Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Facility | None | $138.04 | $138.04 | $138.04 |
United Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $204.17 | Professional | None | $131.83 | $131.83 | $204.17 |
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 $69.18 Median $69.18 Typical High $81.28 | Professional | 52 · Reduced service | $69.18 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $27.54 Typical High $33.11 | Professional | 53 · Discontinued | $27.54 | $27.54 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $20.42 Typical High $24.55 | Professional | 55 · Aftercare only | $20.42 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $13.80 Typical High $16.60 | Professional | 56 · Pre-op care only | $13.80 | $13.80 | $16.60 |
Where Missouri sits
The same service costs 5.5 times more in Texas than in Oregon. 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· 22nd of 51
$141
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.