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 $91.20 Median $91.20 Typical High $107.15 | Facility | None | $91.20 | $91.20 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $91.20 Typical High $107.15 | Professional | None | $87.10 | $91.20 | $107.15 |
Anthem BCBS Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $218.78 | Professional | None | $95.50 | $114.82 | $218.78 |
BCBS Kansas City Setting Professional Modifier None Typical Low $79.43 Median $87.10 Typical High $123.03 | Professional | None | $79.43 | $87.10 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $93.33 Typical High $173.78 | Professional | None | $83.18 | $93.33 | $173.78 |
Medica Setting Facility Modifier None Typical Low $97.72 Median $186.21 Typical High $524.81 | Facility | None | $97.72 | $186.21 | $524.81 |
Medica Setting Professional Modifier None Typical Low $83.18 Median $933.25 Typical High $933.25 | Professional | None | $83.18 | $933.25 | $933.25 |
United Setting Professional Modifier None Typical Low $83.18 Median $93.33 Typical High $144.54 | Professional | None | $83.18 | $93.33 | $144.54 |
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 $43.65 Median $45.71 Typical High $53.70 | Professional | 52 · Reduced service | $43.65 | $45.71 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $18.20 Typical High $21.38 | Professional | 53 · Discontinued | $17.38 | $18.20 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.80 Typical High $16.22 | Professional | 55 · Aftercare only | $13.18 | $13.80 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $9.12 Typical High $10.72 | Professional | 56 · Pre-op care only | $8.71 | $9.12 | $10.72 |
Where Missouri sits
The same service costs 3.1 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· 21st of 51
$112
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.