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 $125.89 Median $125.89 Typical High $147.91 | Facility | None | $125.89 | $125.89 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $147.91 | Professional | None | $120.23 | $125.89 | $147.91 |
Ambetter Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $125.89 Median $154.88 Typical High $239.88 | Professional | None | $125.89 | $154.88 | $239.88 |
BCBS Kansas City Setting Professional Modifier None Typical Low $109.65 Median $120.23 Typical High $173.78 | Professional | None | $109.65 | $120.23 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $131.83 Typical High $234.42 | Professional | None | $114.82 | $131.83 | $234.42 |
Medica Setting Facility Modifier None Typical Low $134.90 Median $229.09 Typical High $1,548.82 | Facility | None | $134.90 | $229.09 | $1,548.82 |
Medica Setting Professional Modifier None Typical Low $117.49 Median $1,174.90 Typical High $1,174.90 | Professional | None | $117.49 | $1,174.90 | $1,174.90 |
United Setting Professional Modifier None Typical Low $112.20 Median $128.82 Typical High $199.53 | Professional | None | $112.20 | $128.82 | $199.53 |
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 $60.26 Median $63.10 Typical High $74.13 | Professional | 52 · Reduced service | $60.26 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $25.12 Typical High $30.20 | Professional | 53 · Discontinued | $23.99 | $25.12 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $19.05 Typical High $22.39 | Professional | 55 · Aftercare only | $18.20 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.59 Typical High $14.79 | Professional | 56 · Pre-op care only | $12.02 | $12.59 | $14.79 |
Where Missouri sits
The same service costs 3.2 times more in Alaska than in Utah. 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· 23rd of 51
$148
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.