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 $128.82 Median $128.82 Typical High $269.15 | Facility | None | $128.82 | $128.82 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $128.82 Typical High $154.88 | Professional | None | $123.03 | $128.82 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
Anthem BCBS Setting Professional Modifier None Typical Low $109.65 Median $128.82 Typical High $190.55 | Professional | None | $109.65 | $128.82 | $190.55 |
BCBS Kansas City Setting Professional Modifier None Typical Low $123.03 Median $128.82 Typical High $141.25 | Professional | None | $123.03 | $128.82 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $269.15 | Professional | None | $102.33 | $138.04 | $269.15 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $186.21 Typical High $562.34 | Facility | None | $123.03 | $186.21 | $562.34 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $186.21 Typical High $776.25 | Professional | None | $125.89 | $186.21 | $776.25 |
United Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
United Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $323.59 | Professional | None | $120.23 | $154.88 | $323.59 |
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 $61.66 Median $64.57 Typical High $75.86 | Professional | 52 · Reduced service | $61.66 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $25.70 Typical High $30.20 | Professional | 53 · Discontinued | $24.55 | $25.70 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $19.50 Typical High $22.91 | Professional | 55 · Aftercare only | $18.20 | $19.50 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.88 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.30 | $12.88 | $15.14 |
Where Missouri sits
The same service costs 2.8 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· 36th of 51
$129
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.