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 $43.65 Median $70.79 Typical High $125.89 | Facility | None | $43.65 | $70.79 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $70.79 Typical High $107.15 | Professional | None | $35.48 | $70.79 | $107.15 |
Ambetter Setting Professional Modifier None Typical Low $48.98 Median $57.54 Typical High $97.72 | Professional | None | $48.98 | $57.54 | $97.72 |
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 $47.86 Median $69.18 Typical High $95.50 | Professional | None | $47.86 | $69.18 | $95.50 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $72.44 Median $104.71 Typical High $141.25 | Professional | 50 · Both sides | $72.44 | $104.71 | $141.25 |
BCBS Kansas City Setting Professional Modifier None Typical Low $39.81 Median $93.33 Typical High $117.49 | Professional | None | $39.81 | $93.33 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $70.79 Typical High $97.72 | Facility | None | $57.54 | $70.79 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $79.43 Typical High $131.83 | Professional | None | $43.65 | $79.43 | $131.83 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $194.98 Typical High $1,380.38 | Facility | None | $54.95 | $194.98 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $91.20 Median $331.13 Typical High $616.60 | Professional | None | $91.20 | $331.13 | $616.60 |
United Setting Facility Modifier None Typical Low $123.03 Median $537.03 Typical High $2,137.96 | Facility | None | $123.03 | $537.03 | $2,137.96 |
United Setting Professional Modifier None Typical Low $45.71 Median $75.86 Typical High $125.89 | Professional | None | $45.71 | $75.86 | $125.89 |
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 $17.78 Median $34.67 Typical High $43.65 | Professional | 52 · Reduced service | $17.78 | $34.67 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $14.13 Typical High $17.38 | Professional | 53 · Discontinued | $7.08 | $14.13 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $10.47 Typical High $12.88 | Professional | 55 · Aftercare only | $5.37 | $10.47 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $7.08 Typical High $8.71 | Professional | 56 · Pre-op care only | $3.55 | $7.08 | $8.71 |
Where Missouri sits
The same service costs 3.8 times more in Alaska than in Virginia. 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· 30th of 51
$83.18
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.