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 $18.62 Median $21.88 Typical High $537.03 | Facility | None | $18.62 | $21.88 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $22.39 Typical High $537.03 | Professional | None | $17.78 | $22.39 | $537.03 |
Anthem BCBS Setting Professional Modifier None Typical Low $17.38 Median $72.44 Typical High $251.19 | Professional | None | $17.38 | $72.44 | $251.19 |
BCBS Kansas City Setting Professional Modifier None Typical Low $16.22 Median $28.84 Typical High $426.58 | Professional | None | $16.22 | $28.84 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $10.96 Median $79.43 Typical High $302.00 | Professional | None | $10.96 | $79.43 | $302.00 |
Medica Setting Facility Modifier None Typical Low $19.95 Median $426.58 Typical High $741.31 | Facility | None | $19.95 | $426.58 | $741.31 |
Medica Setting Professional Modifier None Typical Low $204.17 Median $1,584.89 Typical High $2,951.21 | Professional | None | $204.17 | $1,584.89 | $2,951.21 |
United Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $660.69 | Facility | None | $630.96 | $630.96 | $660.69 |
United Setting Professional Modifier None Typical Low $12.59 Median $91.20 Typical High $426.58 | Professional | None | $12.59 | $91.20 | $426.58 |
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 $8.71 Median $11.22 Typical High $269.15 | Professional | 52 · Reduced service | $8.71 | $11.22 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.55 Median $4.47 Typical High $107.15 | Professional | 53 · Discontinued | $3.55 | $4.47 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $3.39 Typical High $79.43 | Professional | 55 · Aftercare only | $2.63 | $3.39 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.78 Median $2.24 Typical High $53.70 | Professional | 56 · Pre-op care only | $1.78 | $2.24 | $53.70 |
Where Missouri sits
The same service costs 28.2 times more in Hawaii than in Washington, DC. 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· 27th of 51
$120
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.