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 $83.18 Median $109.65 Typical High $199.53 | Facility | None | $83.18 | $109.65 | $199.53 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $109.65 Typical High $154.88 | Professional | None | $83.18 | $109.65 | $154.88 |
Ambetter Setting Professional Modifier None Typical Low $123.03 Median $147.91 Typical High $204.17 | Professional | None | $123.03 | $147.91 | $204.17 |
Anthem BCBS Setting Professional Modifier None Typical Low $97.72 Median $131.83 Typical High $173.78 | Professional | None | $97.72 | $131.83 | $173.78 |
BCBS Kansas City Setting Professional Modifier None Typical Low $100.00 Median $151.36 Typical High $181.97 | Professional | None | $100.00 | $151.36 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $213.80 | Professional | None | $107.15 | $144.54 | $213.80 |
Medica Setting Facility Modifier None Typical Low $112.20 Median $190.55 Typical High $512.86 | Facility | None | $112.20 | $190.55 | $512.86 |
Medica Setting Professional Modifier None Typical Low $141.25 Median $724.44 Typical High $954.99 | Professional | None | $141.25 | $724.44 | $954.99 |
Qualchoice Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $186.21 | Professional | None | $162.18 | $162.18 | $186.21 |
United Setting Professional Modifier None Typical Low $107.15 Median $138.04 Typical High $181.97 | Professional | None | $107.15 | $138.04 | $181.97 |
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 $41.69 Median $53.70 Typical High $67.61 | Professional | 52 · Reduced service | $41.69 | $53.70 | $67.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $16.22 Typical High $19.95 | Professional | 55 · Aftercare only | $12.59 | $16.22 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.96 Typical High $13.49 | Professional | 56 · Pre-op care only | $8.32 | $10.96 | $13.49 |
Ambetter Setting Professional Modifier 25 · Same-day visit Typical Low $123.03 Median $147.91 Typical High $199.53 | Professional | 25 · Same-day visit | $123.03 | $147.91 | $199.53 |
Where Missouri sits
The same service costs 2.7 times more in Alaska 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· 28th of 51
$141
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.