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 $40.74 Median $44.67 Typical High $89.13 | Facility | None | $40.74 | $44.67 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $74.13 Typical High $89.13 | Professional | None | $39.81 | $74.13 | $89.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $89.13 Typical High $114.82 | Professional | None | $64.57 | $89.13 | $114.82 |
BCBS Kansas City Setting Professional Modifier None Typical Low $44.67 Median $95.50 Typical High $109.65 | Professional | None | $44.67 | $95.50 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $87.10 Typical High $104.71 | Professional | None | $50.12 | $87.10 | $104.71 |
Medica Setting Facility Modifier None Typical Low $75.86 Median $154.88 Typical High $1,071.52 | Facility | None | $75.86 | $154.88 | $1,071.52 |
Medica Setting Professional Modifier None Typical Low $75.86 Median $134.90 Typical High $676.08 | Professional | None | $75.86 | $134.90 | $676.08 |
United Setting Facility Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,479.11 | Facility | None | $1,412.54 | $1,412.54 | $1,479.11 |
United Setting Professional Modifier None Typical Low $38.90 Median $58.88 Typical High $109.65 | Professional | None | $38.90 | $58.88 | $109.65 |
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 $19.95 Median $37.15 Typical High $44.67 | Professional | 52 · Reduced service | $19.95 | $37.15 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $14.79 Typical High $18.20 | Professional | 53 · Discontinued | $7.94 | $14.79 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $11.22 Typical High $13.49 | Professional | 55 · Aftercare only | $6.03 | $11.22 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $7.41 Typical High $8.91 | Professional | 56 · Pre-op care only | $3.98 | $7.41 | $8.91 |
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 2.8 times more in Alaska than in Maryland. 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· 18th of 51
$83.18
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.