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 $1,174.90 Median $3,162.28 Typical High $7,762.47 | Facility | None | $1,174.90 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $158.49 Typical High $1,288.25 | Professional | None | $81.28 | $158.49 | $1,288.25 |
Anthem BCBS Setting Professional Modifier None Typical Low $26.30 Median $57.54 Typical High $114.82 | Professional | None | $26.30 | $57.54 | $114.82 |
BCBS Kansas City Setting Professional Modifier None Typical Low $117.49 Median $1,905.46 Typical High $2,630.27 | Professional | None | $117.49 | $1,905.46 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $457.09 Typical High $2,187.76 | Facility | None | $309.03 | $457.09 | $2,187.76 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $1,096.48 Typical High $3,715.35 | Facility | None | $380.19 | $1,096.48 | $3,715.35 |
Medica Setting Professional Modifier None Typical Low $81.28 Median $138.04 Typical High $4,466.84 | Professional | None | $81.28 | $138.04 | $4,466.84 |
United Setting Facility Modifier None Typical Low $398.11 Median $1,148.15 Typical High $2,238.72 | Facility | None | $398.11 | $1,148.15 | $2,238.72 |
United Setting Professional Modifier None Typical Low $75.86 Median $112.20 Typical High $338.84 | Professional | None | $75.86 | $112.20 | $338.84 |
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 $40.74 Median $79.43 Typical High $169.82 | Professional | 52 · Reduced service | $40.74 | $79.43 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $32.36 Typical High $69.18 | Professional | 53 · Discontinued | $16.22 | $32.36 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $23.99 Typical High $51.29 | Professional | 55 · Aftercare only | $12.02 | $23.99 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $15.85 Typical High $34.67 | Professional | 56 · Pre-op care only | $8.13 | $15.85 | $34.67 |
Where Missouri sits
The same service costs 24.5 times more in Texas than in Missouri. 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· 51st of 51
$81.28
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.