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 $40.74 Median $60.26 Typical High $102.33 | Facility | None | $40.74 | $60.26 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $56.23 Typical High $93.33 | Professional | None | $33.88 | $56.23 | $93.33 |
Ambetter Setting Professional Modifier None Typical Low $45.71 Median $61.66 Typical High $100.00 | Professional | None | $45.71 | $61.66 | $100.00 |
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 $40.74 Median $51.29 Typical High $70.79 | Professional | None | $40.74 | $51.29 | $70.79 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $61.66 Median $75.86 Typical High $104.71 | Professional | 50 · Both sides | $61.66 | $75.86 | $104.71 |
BCBS Kansas City Setting Professional Modifier None Typical Low $41.69 Median $75.86 Typical High $95.50 | Professional | None | $41.69 | $75.86 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $66.07 Typical High $66.07 | Facility | None | $50.12 | $66.07 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $57.54 Typical High $102.33 | Professional | None | $41.69 | $57.54 | $102.33 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $190.55 Typical High $1,380.38 | Facility | None | $54.95 | $190.55 | $1,380.38 |
Medica Setting Professional Modifier None Typical Low $70.79 Median $302.00 Typical High $501.19 | Professional | None | $70.79 | $302.00 | $501.19 |
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 $39.81 Median $61.66 Typical High $100.00 | Professional | None | $39.81 | $61.66 | $100.00 |
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 $16.98 Median $28.18 Typical High $34.67 | Professional | 52 · Reduced service | $16.98 | $28.18 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $11.22 Typical High $13.80 | Professional | 53 · Discontinued | $6.76 | $11.22 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $8.32 Typical High $10.47 | Professional | 55 · Aftercare only | $5.13 | $8.32 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $5.62 Typical High $6.92 | Professional | 56 · Pre-op care only | $3.39 | $5.62 | $6.92 |
Where Missouri sits
The same service costs 4.0 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· 35th of 51
$64.57
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.