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 $70.79 Median $83.18 Typical High $97.72 | Facility | None | $70.79 | $83.18 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $81.28 Typical High $97.72 | Professional | None | $67.61 | $81.28 | $97.72 |
Anthem BCBS Setting Professional Modifier None Typical Low $61.66 Median $75.86 Typical High $117.49 | Professional | None | $61.66 | $75.86 | $117.49 |
BCBS Kansas City Setting Professional Modifier None Typical Low $61.66 Median $81.28 Typical High $89.13 | Professional | None | $61.66 | $81.28 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $81.28 Typical High $138.04 | Professional | None | $64.57 | $81.28 | $138.04 |
Medica Setting Facility Modifier None Typical Low $67.61 Median $131.83 Typical High $309.03 | Facility | None | $67.61 | $131.83 | $309.03 |
Medica Setting Professional Modifier None Typical Low $77.62 Median $177.83 Typical High $512.86 | Professional | None | $77.62 | $177.83 | $512.86 |
United Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
United Setting Professional Modifier None Typical Low $66.07 Median $91.20 Typical High $181.97 | Professional | None | $66.07 | $91.20 | $181.97 |
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 $33.88 Median $40.74 Typical High $48.98 | Professional | 52 · Reduced service | $33.88 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $16.22 Typical High $19.50 | Professional | 53 · Discontinued | $13.49 | $16.22 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $12.30 Typical High $14.45 | Professional | 55 · Aftercare only | $10.00 | $12.30 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $8.13 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.76 | $8.13 | $9.77 |
Where Missouri sits
The same service costs 8.1 times more in Alaska than in Indiana. 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· 34th of 51
$79.43
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.