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 $112.20 Median $112.20 Typical High $131.83 | Facility | None | $112.20 | $112.20 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $112.20 Typical High $131.83 | Professional | None | $104.71 | $112.20 | $131.83 |
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 $97.72 Median $138.04 Typical High $177.83 | Professional | None | $97.72 | $138.04 | $177.83 |
BCBS Kansas City Setting Professional Modifier None Typical Low $109.65 Median $123.03 Typical High $173.78 | Professional | None | $109.65 | $123.03 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $131.83 Typical High $239.88 | Professional | None | $102.33 | $131.83 | $239.88 |
Medica Setting Facility Modifier None Typical Low $117.49 Median $173.78 Typical High $478.63 | Facility | None | $117.49 | $173.78 | $478.63 |
Medica Setting Professional Modifier None Typical Low $112.20 Median $691.83 Typical High $691.83 | Professional | None | $112.20 | $691.83 | $691.83 |
United Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $281.84 | Professional | None | $107.15 | $134.90 | $281.84 |
5 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 $52.48 Median $56.23 Typical High $66.07 | Professional | 52 · Reduced service | $52.48 | $56.23 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $22.39 Typical High $26.30 | Professional | 53 · Discontinued | $20.89 | $22.39 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.98 Typical High $19.95 | Professional | 55 · Aftercare only | $15.85 | $16.98 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $11.22 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.47 | $11.22 | $13.18 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | 59 · Distinct service | $134.90 | $134.90 | $134.90 |
Where Missouri sits
The same service costs 2.8 times more in Alaska than in Texas. 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· 20th of 51
$138
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.