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 $57.54 Median $81.28 Typical High $147.91 | Facility | None | $57.54 | $81.28 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $81.28 Typical High $123.03 | Professional | None | $57.54 | $81.28 | $123.03 |
Ambetter Setting Professional Modifier None Typical Low $114.82 Median $138.04 Typical High $162.18 | Professional | None | $114.82 | $138.04 | $162.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $204.17 Median $3,467.37 Typical High $7,079.46 | Facility | None | $204.17 | $3,467.37 | $7,079.46 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $83.18 Typical High $114.82 | Professional | None | $69.18 | $83.18 | $114.82 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $102.33 Median $125.89 Typical High $169.82 | Professional | 50 · Both sides | $102.33 | $125.89 | $169.82 |
BCBS Kansas City Setting Professional Modifier None Typical Low $66.07 Median $104.71 Typical High $131.83 | Professional | None | $66.07 | $104.71 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $79.43 Typical High $109.65 | Facility | None | $58.88 | $79.43 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $100.00 Typical High $165.96 | Professional | None | $64.57 | $100.00 | $165.96 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $269.15 Typical High $1,288.25 | Facility | None | $54.95 | $269.15 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $102.33 Median $501.19 Typical High $724.44 | Professional | None | $102.33 | $501.19 | $724.44 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,137.96 | Facility | None | $123.03 | $602.56 | $2,137.96 |
United Setting Professional Modifier None Typical Low $69.18 Median $104.71 Typical High $154.88 | Professional | None | $69.18 | $104.71 | $154.88 |
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 $28.84 Median $40.74 Typical High $50.12 | Professional | 52 · Reduced service | $28.84 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $16.22 Typical High $20.42 | Professional | 53 · Discontinued | $11.48 | $16.22 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $12.30 Typical High $15.14 | Professional | 55 · Aftercare only | $8.71 | $12.30 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $8.13 Typical High $10.23 | Professional | 56 · Pre-op care only | $5.75 | $8.13 | $10.23 |
Where Missouri sits
The same service costs 3.6 times more in Alaska than in Kentucky. 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· 34th of 51
$100
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.