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 $81.28 Median $3,162.28 Typical High $7,762.47 | Facility | None | $81.28 | $3,162.28 | $7,762.47 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $162.18 Typical High $239.88 | Professional | None | $66.07 | $162.18 | $239.88 |
Ambetter Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $77.62 Median $109.65 Typical High $263.03 | Professional | None | $77.62 | $109.65 | $263.03 |
BCBS Kansas City Setting Professional Modifier None Typical Low $56.23 Median $190.55 Typical High $257.04 | Professional | None | $56.23 | $190.55 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $162.18 Typical High $316.23 | Professional | None | $64.57 | $162.18 | $316.23 |
Medica Setting Facility Modifier None Typical Low $67.61 Median $190.55 Typical High $363.08 | Facility | None | $67.61 | $190.55 | $363.08 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $741.31 Typical High $1,230.27 | Professional | None | $177.83 | $741.31 | $1,230.27 |
United Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
United Setting Professional Modifier None Typical Low $69.18 Median $158.49 Typical High $302.00 | Professional | None | $69.18 | $158.49 | $302.00 |
6 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 $32.36 Median $63.10 Typical High $120.23 | Professional | 52 · Reduced service | $32.36 | $63.10 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $25.12 Typical High $47.86 | Professional | 53 · Discontinued | $13.18 | $25.12 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $48.98 Median $95.50 Typical High $177.83 | Professional | 54 · Surgery only | $48.98 | $95.50 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $19.05 Typical High $35.48 | Professional | 55 · Aftercare only | $9.77 | $19.05 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $12.59 Typical High $23.99 | Professional | 56 · Pre-op care only | $6.61 | $12.59 | $23.99 |
Qualchoice Setting Professional Modifier GN · Speech therapy plan Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | GN · Speech therapy plan | $281.84 | $281.84 | $281.84 |
Where Missouri sits
The same service costs 2.9 times more in Washington than in Kentucky. 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· 26th of 51
$174
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.