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 $302.00 Median $302.00 Typical High $354.81 | Facility | None | $302.00 | $302.00 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $302.00 Typical High $363.08 | Professional | None | $288.40 | $302.00 | $363.08 |
Ambetter Setting Professional Modifier None Typical Low $263.03 Median $354.81 Typical High $467.74 | Professional | None | $263.03 | $354.81 | $467.74 |
Anthem BCBS Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $426.58 | Professional | None | $229.09 | $269.15 | $426.58 |
BCBS Kansas City Setting Professional Modifier None Typical Low $316.23 Median $346.74 Typical High $478.63 | Professional | None | $316.23 | $346.74 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $288.40 Typical High $478.63 | Professional | None | $251.19 | $288.40 | $478.63 |
Medica Setting Facility Modifier None Typical Low $302.00 Median $436.52 Typical High $1,318.26 | Facility | None | $302.00 | $436.52 | $1,318.26 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $588.84 Typical High $1,905.46 | Professional | None | $223.87 | $588.84 | $1,905.46 |
United Setting Professional Modifier None Typical Low $218.78 Median $245.47 Typical High $407.38 | Professional | None | $218.78 | $245.47 | $407.38 |
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 $144.54 Median $151.36 Typical High $177.83 | Professional | 52 · Reduced service | $144.54 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $60.26 Typical High $70.79 | Professional | 53 · Discontinued | $57.54 | $60.26 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $45.71 Typical High $53.70 | Professional | 55 · Aftercare only | $43.65 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $30.20 Typical High $35.48 | Professional | 56 · Pre-op care only | $28.84 | $30.20 | $35.48 |
Where Missouri sits
The same service costs 2.8 times more in Alaska than in New York. 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· 41st of 51
$282
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.