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 $18.20 Median $18.20 Typical High $21.38 | Facility | None | $18.20 | $18.20 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $17.38 Median $18.20 Typical High $21.38 | Professional | None | $17.38 | $18.20 | $21.38 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.62 Median $21.88 Typical High $29.51 | Professional | None | $18.62 | $21.88 | $29.51 |
BCBS Kansas City Setting Professional Modifier None Typical Low $19.05 Median $20.42 Typical High $28.84 | Professional | None | $19.05 | $20.42 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $19.05 Typical High $33.11 | Professional | None | $16.60 | $19.05 | $33.11 |
Medica Setting Facility Modifier None Typical Low $19.50 Median $28.84 Typical High $104.71 | Facility | None | $19.50 | $28.84 | $104.71 |
Medica Setting Professional Modifier None Typical Low $16.98 Median $44.67 Typical High $162.18 | Professional | None | $16.98 | $44.67 | $162.18 |
United Setting Professional Modifier None Typical Low $16.60 Median $19.05 Typical High $30.20 | Professional | None | $16.60 | $19.05 | $30.20 |
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 $8.71 Median $9.12 Typical High $10.72 | Professional | 52 · Reduced service | $8.71 | $9.12 | $10.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $3.63 Typical High $4.27 | Professional | 53 · Discontinued | $3.47 | $3.63 | $4.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $2.75 Typical High $3.24 | Professional | 55 · Aftercare only | $2.57 | $2.75 | $3.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $1.82 Typical High $2.14 | Professional | 56 · Pre-op care only | $1.74 | $1.82 | $2.14 |
Where Missouri sits
The same service costs 3.4 times more in Alaska than in Florida. 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· 26th of 51
$21.38
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.