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 $109.65 Median $147.91 Typical High $316.23 | Facility | None | $109.65 | $147.91 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $154.88 Typical High $257.04 | Professional | None | $123.03 | $154.88 | $257.04 |
Ambetter Setting Professional Modifier None Typical Low $181.97 Median $186.21 Typical High $275.42 | Professional | None | $181.97 | $186.21 | $275.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $213.80 Median $251.19 Typical High $346.74 | Professional | None | $213.80 | $251.19 | $346.74 |
BCBS Kansas City Setting Professional Modifier None Typical Low $186.21 Median $194.98 Typical High $281.84 | Professional | None | $186.21 | $194.98 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $426.58 | Professional | None | $194.98 | $245.47 | $426.58 |
Medica Setting Facility Modifier None Typical Low $229.09 Median $323.59 Typical High $933.25 | Facility | None | $229.09 | $323.59 | $933.25 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $1,288.25 Typical High $1,288.25 | Professional | None | $199.53 | $1,288.25 | $1,288.25 |
United Setting Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $338.84 | Professional | None | $186.21 | $234.42 | $338.84 |
3 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 $74.13 Median $87.10 Typical High $91.20 | Professional | 52 · Reduced service | $74.13 | $87.10 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $26.30 Typical High $27.54 | Professional | 55 · Aftercare only | $21.88 | $26.30 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $17.38 Typical High $18.20 | Professional | 56 · Pre-op care only | $14.79 | $17.38 | $18.20 |
Where Missouri sits
The same service costs 2.4 times more in Alaska than in Utah. 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· 18th of 51
$251
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.