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 $11.75 Median $11.75 Typical High $16.60 | Facility | None | $11.75 | $11.75 | $16.60 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $11.75 Typical High $13.80 | Professional | None | $11.22 | $11.75 | $13.80 |
Ambetter Setting Professional Modifier None Typical Low $10.72 Median $15.49 Typical High $16.60 | Professional | None | $10.72 | $15.49 | $16.60 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,659.59 | Facility | None | $1,479.11 | $1,479.11 | $1,659.59 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.72 Median $12.30 Typical High $14.45 | Professional | None | $10.72 | $12.30 | $14.45 |
BCBS Kansas City Setting Professional Modifier None Typical Low $10.23 Median $12.88 Typical High $25.12 | Professional | None | $10.23 | $12.88 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $10.72 Median $14.13 Typical High $24.55 | Professional | None | $10.72 | $14.13 | $24.55 |
Medica Setting Facility Modifier None Typical Low $11.75 Median $41.69 Typical High $100.00 | Facility | None | $11.75 | $41.69 | $100.00 |
Medica Setting Professional Modifier None Typical Low $12.02 Median $70.79 Typical High $70.79 | Professional | None | $12.02 | $70.79 | $70.79 |
Qualchoice Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | None | $16.60 | $16.60 | $16.60 |
United Setting Professional Modifier None Typical Low $10.96 Median $16.22 Typical High $30.20 | Professional | None | $10.96 | $16.22 | $30.20 |
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 $5.62 Median $5.89 Typical High $6.92 | Professional | 52 · Reduced service | $5.62 | $5.89 | $6.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.40 Typical High $2.82 | Professional | 53 · Discontinued | $2.24 | $2.40 | $2.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.70 Median $1.78 Typical High $2.09 | Professional | 55 · Aftercare only | $1.70 | $1.78 | $2.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.20 Typical High $1.41 | Professional | 56 · Pre-op care only | $1.12 | $1.20 | $1.41 |
Where Missouri sits
The same service costs 2.6 times more in Alaska 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
$12.59
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.