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 $16.22 Median $18.20 Typical High $70.79 | Facility | None | $16.22 | $18.20 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $40.74 Typical High $70.79 | Professional | None | $16.60 | $40.74 | $70.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $28.84 Median $60.26 Typical High $75.86 | Professional | None | $28.84 | $60.26 | $75.86 |
BCBS Kansas City Setting Professional Modifier None Typical Low $18.62 Median $58.88 Typical High $87.10 | Professional | None | $18.62 | $58.88 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $52.48 Typical High $77.62 | Professional | None | $19.95 | $52.48 | $77.62 |
Medica Setting Facility Modifier None Typical Low $31.62 Median $85.11 Typical High $346.74 | Facility | None | $31.62 | $85.11 | $346.74 |
Medica Setting Professional Modifier None Typical Low $56.23 Median $104.71 Typical High $524.81 | Professional | None | $56.23 | $104.71 | $524.81 |
United Setting Facility Modifier None Typical Low $416.87 Median $416.87 Typical High $446.68 | Facility | None | $416.87 | $416.87 | $446.68 |
United Setting Professional Modifier None Typical Low $18.20 Median $38.90 Typical High $83.18 | Professional | None | $18.20 | $38.90 | $83.18 |
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 $8.13 Median $20.42 Typical High $35.48 | Professional | 52 · Reduced service | $8.13 | $20.42 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $11.22 Typical High $14.13 | Professional | 53 · Discontinued | $3.31 | $11.22 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $8.32 Typical High $10.47 | Professional | 55 · Aftercare only | $2.45 | $8.32 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $5.62 Typical High $7.08 | Professional | 56 · Pre-op care only | $1.62 | $5.62 | $7.08 |
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 4.4 times more in Hawaii than in Washington, DC. 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· 15th of 51
$60.26
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.