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 $44.67 Median $77.62 Typical High $169.82 | Facility | None | $44.67 | $77.62 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $44.67 Median $77.62 Typical High $87.10 | Professional | None | $44.67 | $77.62 | $87.10 |
Anthem BCBS Setting Professional Modifier None Typical Low $69.18 Median $89.13 Typical High $134.90 | Professional | None | $69.18 | $89.13 | $134.90 |
BCBS Kansas City Setting Professional Modifier None Typical Low $51.29 Median $97.72 Typical High $112.20 | Professional | None | $51.29 | $97.72 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $91.20 Typical High $100.00 | Professional | None | $54.95 | $91.20 | $100.00 |
Medica Setting Facility Modifier None Typical Low $63.10 Median $128.82 Typical High $257.04 | Facility | None | $63.10 | $128.82 | $257.04 |
Medica Setting Professional Modifier None Typical Low $70.79 Median $128.82 Typical High $741.31 | Professional | None | $70.79 | $128.82 | $741.31 |
United Setting Professional Modifier None Typical Low $38.90 Median $64.57 Typical High $107.15 | Professional | None | $38.90 | $64.57 | $107.15 |
5 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 $22.39 Median $38.90 Typical High $42.66 | Professional | 52 · Reduced service | $22.39 | $38.90 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $15.49 Typical High $17.38 | Professional | 53 · Discontinued | $8.91 | $15.49 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $11.48 Typical High $12.88 | Professional | 55 · Aftercare only | $6.76 | $11.48 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $7.76 Typical High $8.51 | Professional | 56 · Pre-op care only | $4.47 | $7.76 | $8.51 |
United Setting Professional Modifier XC Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | XC | $501.19 | $501.19 | $501.19 |
Where Missouri sits
The same service costs 3.0 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· 23rd of 51
$81.28
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.