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 $26.30 Median $39.81 Typical High $61.66 | Facility | None | $26.30 | $39.81 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $35.48 Typical High $69.18 | Professional | None | $27.54 | $35.48 | $69.18 |
Ambetter Setting Professional Modifier None Typical Low $37.15 Median $46.77 Typical High $67.61 | Professional | None | $37.15 | $46.77 | $67.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $35.48 Median $47.86 Typical High $66.07 | Professional | None | $35.48 | $47.86 | $66.07 |
BCBS Kansas City Setting Professional Modifier None Typical Low $43.65 Median $45.71 Typical High $61.66 | Professional | None | $43.65 | $45.71 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $47.86 Typical High $79.43 | Professional | None | $39.81 | $47.86 | $79.43 |
Medica Setting Facility Modifier None Typical Low $48.98 Median $57.54 Typical High $218.78 | Facility | None | $48.98 | $57.54 | $218.78 |
Medica Setting Professional Modifier None Typical Low $36.31 Median $346.74 Typical High $346.74 | Professional | None | $36.31 | $346.74 | $346.74 |
United Setting Professional Modifier None Typical Low $33.88 Median $43.65 Typical High $70.79 | Professional | None | $33.88 | $43.65 | $70.79 |
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 $17.38 Median $20.89 Typical High $21.38 | Professional | 52 · Reduced service | $17.38 | $20.89 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $6.17 Typical High $6.46 | Professional | 55 · Aftercare only | $5.25 | $6.17 | $6.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $4.17 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.47 | $4.17 | $4.27 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $42.66 Median $60.26 Typical High $67.61 | Professional | 25 · Same-day visit | $42.66 | $60.26 | $67.61 |
Where Missouri sits
The same service costs 2.7 times more in Alaska than in New Jersey. 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· 34th of 51
$46.77
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.