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 $10.23 Median $11.48 Typical High $11.48 | Facility | None | $10.23 | $11.48 | $11.48 |
Aetna Setting Professional Modifier None Typical Low $10.23 Median $11.48 Typical High $13.18 | Professional | None | $10.23 | $11.48 | $13.18 |
Anthem BCBS Setting Professional Modifier None Typical Low $16.22 Median $69.18 Typical High $467.74 | Professional | None | $16.22 | $69.18 | $467.74 |
BCBS Kansas City Setting Professional Modifier None Typical Low $14.13 Median $14.79 Typical High $15.85 | Professional | None | $14.13 | $14.79 | $15.85 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $13.18 Typical High $19.95 | Professional | None | $12.02 | $13.18 | $19.95 |
Medica Setting Facility Modifier None Typical Low $14.13 Median $131.83 Typical High $645.65 | Facility | None | $14.13 | $131.83 | $645.65 |
Medica Setting Professional Modifier None Typical Low $11.22 Median $28.84 Typical High $1,905.46 | Professional | None | $11.22 | $28.84 | $1,905.46 |
United Setting Facility Modifier None Typical Low $117.49 Median $117.49 Typical High $123.03 | Facility | None | $117.49 | $117.49 | $123.03 |
United Setting Professional Modifier None Typical Low $11.22 Median $26.30 Typical High $37.15 | Professional | None | $11.22 | $26.30 | $37.15 |
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 $5.13 Median $5.62 Typical High $6.61 | Professional | 52 · Reduced service | $5.13 | $5.62 | $6.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.04 Median $2.29 Typical High $2.63 | Professional | 53 · Discontinued | $2.04 | $2.29 | $2.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.70 Typical High $1.95 | Professional | 55 · Aftercare only | $1.51 | $1.70 | $1.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.02 Median $1.12 Typical High $1.32 | Professional | 56 · Pre-op care only | $1.02 | $1.12 | $1.32 |
Where Missouri sits
The same service costs 43.7 times more in Hawaii 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· 16th of 51
$18.20
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.