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 $43.65 Median $58.88 Typical High $109.65 | Facility | None | $43.65 | $58.88 | $109.65 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $61.66 Typical High $120.23 | Professional | None | $48.98 | $61.66 | $120.23 |
Ambetter Setting Professional Modifier None Typical Low $72.44 Median $87.10 Typical High $114.82 | Professional | None | $72.44 | $87.10 | $114.82 |
Anthem BCBS Setting Professional Modifier None Typical Low $83.18 Median $91.20 Typical High $158.49 | Professional | None | $83.18 | $91.20 | $158.49 |
BCBS Kansas City Setting Professional Modifier None Typical Low $72.44 Median $75.86 Typical High $117.49 | Professional | None | $72.44 | $75.86 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $107.15 Typical High $173.78 | Professional | None | $79.43 | $107.15 | $173.78 |
Medica Setting Facility Modifier None Typical Low $91.20 Median $151.36 Typical High $371.54 | Facility | None | $91.20 | $151.36 | $371.54 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $616.60 Typical High $616.60 | Professional | None | $87.10 | $616.60 | $616.60 |
United Setting Professional Modifier None Typical Low $85.11 Median $109.65 Typical High $154.88 | Professional | None | $85.11 | $109.65 | $154.88 |
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 $29.51 Median $34.67 Typical High $39.81 | Professional | 52 · Reduced service | $29.51 | $34.67 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $10.47 Typical High $11.75 | Professional | 55 · Aftercare only | $8.71 | $10.47 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $6.92 Typical High $7.94 | Professional | 56 · Pre-op care only | $5.89 | $6.92 | $7.94 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $74.13 Median $97.72 Typical High $114.82 | Professional | 25 · Same-day visit | $74.13 | $97.72 | $114.82 |
Ambetter Setting Professional Modifier 57 · Decision for surgery Typical Low $85.11 Median $114.82 Typical High $114.82 | Professional | 57 · Decision for surgery | $85.11 | $114.82 | $114.82 |
Where Missouri sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 37th of 51
$93.33
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.