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 $19.95 Median $19.95 Typical High $30.20 | Facility | None | $19.95 | $19.95 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $23.44 | Professional | None | $19.95 | $19.95 | $23.44 |
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 $27.54 Median $33.88 Typical High $38.90 | Professional | None | $27.54 | $33.88 | $38.90 |
BCBS Kansas City Setting Professional Modifier None Typical Low $25.12 Median $26.92 Typical High $37.15 | Professional | None | $25.12 | $26.92 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $549.54 | Facility | None | $467.74 | $467.74 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $26.92 Typical High $51.29 | Professional | None | $17.78 | $26.92 | $51.29 |
Medica Setting Facility Modifier None Typical Low $20.89 Median $46.77 Typical High $602.56 | Facility | None | $20.89 | $46.77 | $602.56 |
Medica Setting Professional Modifier None Typical Low $30.90 Median $58.88 Typical High $165.96 | Professional | None | $30.90 | $58.88 | $165.96 |
United Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $724.44 | Facility | None | $691.83 | $691.83 | $724.44 |
United Setting Professional Modifier None Typical Low $26.30 Median $34.67 Typical High $46.77 | Professional | None | $26.30 | $34.67 | $46.77 |
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 $10.00 Median $10.00 Typical High $11.75 | Professional | 52 · Reduced service | $10.00 | $10.00 | $11.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $3.98 Typical High $4.68 | Professional | 53 · Discontinued | $3.98 | $3.98 | $4.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $3.02 Typical High $3.47 | Professional | 55 · Aftercare only | $2.95 | $3.02 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $2.00 Typical High $2.34 | Professional | 56 · Pre-op care only | $2.00 | $2.00 | $2.34 |
Where Missouri sits
The same service costs 2.5 times more in Iowa than in Pennsylvania. 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· 24th of 51
$33.11
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.