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 $239.88 Median $239.88 Typical High $275.42 | Facility | None | $239.88 | $239.88 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $239.88 Typical High $288.40 | Professional | None | $208.93 | $239.88 | $288.40 |
Ambetter Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
Anthem BCBS Setting Professional Modifier None Typical Low $158.49 Median $194.98 Typical High $363.08 | Professional | None | $158.49 | $194.98 | $363.08 |
BCBS Kansas City Setting Professional Modifier None Typical Low $208.93 Median $223.87 Typical High $245.47 | Professional | None | $208.93 | $223.87 | $245.47 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $478.63 Typical High $575.44 | Facility | None | $302.00 | $478.63 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $218.78 Typical High $398.11 | Professional | None | $194.98 | $218.78 | $398.11 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $446.68 Typical High $1,288.25 | Facility | None | $123.03 | $446.68 | $1,288.25 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $346.74 Typical High $1,513.56 | Professional | None | $169.82 | $346.74 | $1,513.56 |
United Setting Facility Modifier None Typical Low $123.03 Median $602.56 Typical High $2,137.96 | Facility | None | $123.03 | $602.56 | $2,137.96 |
United Setting Professional Modifier None Typical Low $169.82 Median $263.03 Typical High $524.81 | Professional | None | $169.82 | $263.03 | $524.81 |
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 $104.71 Median $117.49 Typical High $138.04 | Professional | 52 · Reduced service | $104.71 | $117.49 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $47.86 Typical High $54.95 | Professional | 53 · Discontinued | $41.69 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $35.48 Typical High $41.69 | Professional | 55 · Aftercare only | $31.62 | $35.48 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $23.99 Typical High $27.54 | Professional | 56 · Pre-op care only | $20.89 | $23.99 | $27.54 |
Where Missouri sits
The same service costs 3.0 times more in Wisconsin than in Florida. 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· 38th of 51
$224
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.